异体骨与自体骨植骨对胫骨骨折术后骨不连的疗效分析  

Efficacy of different bone graft in treatment of nonunion of tibial fractures

作　　者：柴臻 王福平[1] 李宏伟[1] 任龙龙[1] 

机构地区：[1]榆林市第二医院骨二科,陕西榆林719000

出　　处：《西南国防医药》2016年第10期1104-1107,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨自体植骨与异体植骨对胫骨中下段骨折术后骨不连的疗效。方法选取90例胫骨骨折术后骨不连患者,按照入院时间段分为两组,自体植骨组(46例)采取锁定加压钢板结合自体植骨治疗,异体植骨组(44例)采取锁定加压钢板结合异体植骨治疗。观察比较两组围手术期参数、术后3个月膝关节评分及随访12个月期间并发症发生情况,评价自体植骨与异体植骨对胫骨中下段骨折术后骨不连的疗效。结果自体植骨组在住院时间、骨痂生长时间、骨折愈合时间上均明显少于异体植骨组(P<0.05),而两组在术中出血量和手术时间上相比,没有统计学差异(P>0.05);术后3个月,两组在疼痛度评分、活动度评分、稳定性评分、KSS总评分上相比,没有统计学差异(P>0.05);随访12个月期间,自体植骨组出现2例伤口红肿、渗液,并发症发生率为4.3%;异体植骨组出现6例伤口红肿、渗液,2例皮肤坏死,1例骨折愈合延迟,并发症发生率为20.4%,明显高于自体植骨组(P<0.05)。结论锁定加压钢板结合自体植骨对胫骨中下段骨折术后骨不连具有良好的疗效,可以明显缩短骨折愈合时间,术后并发症较少,值得临床推广使用。Objective To explore the efficacy of autografts and allografts in the treatment of nonunion of tibial fractures. Methods A total 90 patients with nonunion of tibial fractures were selected and divided into two groups according to the date of admission. The autografts group （n = 46） was treated with locking compression plate （LCP） combined with autografts, and the allografts group （n = 44） was treated with LCP combined with allografts. Three months after the operation and the incidence of adverse reactions within the 12-month follow-up visit, the perioperative parameters, knee score in the two groups were observed and compared in order to evaluate the efficacy of autografts and allografts in the treatment of nonunion of tibial fractures, Results The LOS, callus growth time and fracture healing time in the autograft groups were apparently shorter than those in the allografts group （P 〈 0.05）. There was no statistical difference in intraoperative amount of bleeding and the duration of operation between the two groups （P 〉 0.05）. Three months after the surgery, there was no statistical difference in the pain score, activity score, stability score and KSS total score between the two groups （P 〉 0.05）. During the 12-month follow-up visit, there were two wound inflammation and oozing in the autografts group, thus the incidence of complications was 4.3%; there was six wound inflammation and oozing, two cutaneous necrosis and one delayed union in the allografts group, thus the incidence of complications was 20.4%, which was much higher than that in the autografts group（P 〈 0.05）. Conclusion LCP combined with autografts has good effects on the treatment of nonunion of tibial fracture, and can shorten the fracture healing time and reduce complications. Therefore, it is worthy of clinical popularization and application.

关 键 词：胫骨骨折 自体植骨 异体植骨 骨不连 并发症 

分 类 号：R683.42[医药卫生—骨科学]