一期原位骨延长技术治疗四肢火器伤骨缺损的研究  

Primary shortening followed by bone lengthening in situ for the treatment of gunshot bone defect

作　　者：侯树勋[1] 章亚东[1] 孙大铭[1] 张伟佳[1] 孙彦[1] 张春丽[1] 

机构地区：[1]解放军第三○四医院骨科,北京100037

出　　处：《中华外科杂志》1999年第8期503-506,I036,共5页Chinese Journal of Surgery

摘　　要：目的　探讨四肢火器伤骨缺损的治疗方法和一期原位骨延长技术的生物学基础。　方法　对犬肢体火器伤骨缺损模型分别采用一期原位骨延长和传统的后期骨移植两种方法治疗，比较其骨愈合的病理过程及局部微循环血流量的变化。　结果　两组动物骨折局部血流量无显著差别。一期原位骨延长组８ 周内骨延长长度为２８２ ±０９４ ｃｍ ， 相对长度为１９３ ％ （１５８ ％ ～２１４ ％ ） 。其骨愈合时间明显比后期植骨组短，伤肢功能也较好。软骨内化骨是骨延长过程中主要的成骨形式。　结论　一期原位骨延长技术治疗火器伤骨缺损，在缩短疗程，简化操作等方面具有明显优越性，且对火器伤骨折的愈合过程和局部血液循环无明显不良影响。Objective To study the treatment of gunshot bone defect and the biological basis of primary shortening followed by callus distraction in situ. Methods The canine with gunshot bone defect were treated by two methods,primary shortening followed by callus distraction or delayed bone graft.The local blood flow and pathomorphological change were observed and compared with each other. Results In the experiment,the bone lengthening was stopped at the 56th day with (2 82±0 94) cm (19 3%) gain in the group of bone lengthening, and the time of bone healing was much shorter in the group of bone lengthening than in the group of delayed graft. There was no significancant difference between the groups in the time of soft tissue healing and local blood flow. Conclusions The technique of primary bone lengthening is simpl and has no side effect on tissue healing and local blood flow.

关 键 词：火器伤 原位骨延长 四肢骨缺损 

分 类 号：R683.405[医药卫生—骨科学] R826.5[医药卫生—外科学]