骨搬运技术治疗下肢大段骨缺损
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摘要
目的探讨应用骨搬运治疗下肢大段骨缺损的临床疗效。方法应用骨搬运技术治疗12例下肢大段骨缺损患者(骨缺损5~10 cm)。在截骨术后7~14 d开始骨搬运,每天4~6次,每次1/6~1/4 mm。记录术后骨痂牵拉时间、骨愈合时间、支架固定时间及活动功能情况,进行疗效评定。结果患者均获得随访,时间12~36个月。骨搬运时间55~142 d;骨愈合时间5~13个月;外固定支架携带时间7~16个月。根据Paley et al方法评价骨搬运结果及功能,骨搬运结果:优10例,良2例;功能评价:优7例,良3,可2例。结论应用外固定架牵开进行骨搬运是治疗下肢大段骨缺损的有效方法。
Objective To evaluate the clinical curative effect by using bone transport to treat the lower limbs bone defect. Methods Twelve cases of lower limbs long bone defect were treated with bone transport,the bone defects ranged 5 ~ 10 cm. Transport were porformed on 7 ~ 14 d postoperatively,4 ~ 6 times every day,every time 1 /6 ~ 1 /4mm. Postoperative callus pull time,bone union time,bracket fixed time and activity function were recorded for effect analysis and evaluation. Results All the patients were followed up for 12 ~ 36 months. Bone transport time was55 ~ 142 d. Bone union time was 5 ~ 13 months. External fixator time was 7 ~ 16 months. According to Paley's evaluation system,10 cases were excellent and 2 cases were good for bone union. 7 cases were excellent,3 cases were good,2 cases were fair for function evaluation. Conclusions It is effective for treatment of bone defect with bone transport by external fixator.
Objective To evaluate the clinical curative effect by using bone transport to treat the lower limbs bone defect. Methods Twelve cases of lower limbs long bone defect were treated with bone transport,the bone defects ranged 5 ~ 10 cm. Transport were porformed on 7 ~ 14 d postoperatively,4 ~ 6 times every day,every time 1 /6 ~ 1 /4mm. Postoperative callus pull time,bone union time,bracket fixed time and activity function were recorded for effect analysis and evaluation. Results All the patients were followed up for 12 ~ 36 months. Bone transport time was55 ~ 142 d. Bone union time was 5 ~ 13 months. External fixator time was 7 ~ 16 months. According to Paley's evaluation system,10 cases were excellent and 2 cases were good for bone union. 7 cases were excellent,3 cases were good,2 cases were fair for function evaluation. Conclusions It is effective for treatment of bone defect with bone transport by external fixator.
引文
[1]Paley D,Catagni M A,Argnani F,et al.Ilizarov treatment of tibial nonunions with bone loss[J].Clin Orthop Relat Res,1989,241:146-165.
[2]林家钟,王新家.大块骨缺损的修复研究现状及进展[J].医学综述,2009,15(6):877-880.
[3]艾田,张俊德,程添栋,等.伊里扎诺夫技术修复兔胫骨骨缺损成骨机制的研究[J].临床骨科杂志,2012,15(2):202-204.
[4]王军,魏华,张永飞,等.骨搬运技术治疗胫骨骨缺损疗效及影响因素分析[J].中国骨与关节损伤杂志,2016,31(2):164-167.
[5]滕星,黄雷,杨胜松,等.应用混合式外固定支架骨搬运技术治疗胫骨干骺端骨缺损[J].中华创伤骨科杂志,2013,15(10):834-839.
[6]肖樵苏,张先文,叶俊武,等.应用骨搬运术同期治疗合并难治性软组织缺损的胫骨大段骨缺损[J].中国修复重建外科杂志,2016,30(8):961-965.
[2]林家钟,王新家.大块骨缺损的修复研究现状及进展[J].医学综述,2009,15(6):877-880.
[3]艾田,张俊德,程添栋,等.伊里扎诺夫技术修复兔胫骨骨缺损成骨机制的研究[J].临床骨科杂志,2012,15(2):202-204.
[4]王军,魏华,张永飞,等.骨搬运技术治疗胫骨骨缺损疗效及影响因素分析[J].中国骨与关节损伤杂志,2016,31(2):164-167.
[5]滕星,黄雷,杨胜松,等.应用混合式外固定支架骨搬运技术治疗胫骨干骺端骨缺损[J].中华创伤骨科杂志,2013,15(10):834-839.
[6]肖樵苏,张先文,叶俊武,等.应用骨搬运术同期治疗合并难治性软组织缺损的胫骨大段骨缺损[J].中国修复重建外科杂志,2016,30(8):961-965.