单臂轨道式外固定支架治疗胫骨创伤后骨缺损的中远期效果观察  

Effect of Middle and Long Term Follow-up of Single Track External Fixator in the Treatment of Bone Defect of Tibia

作　　者：张弛[1] 王钊[1] 胡汉生[1] 王簕[1] 刘松[1] 

机构地区：[1]广州医科大学附属第三医院,广东广州510150

出　　处：《现代医院》2017年第7期1037-1039,1043,共4页Modern Hospitals

基　　金：广州市医药卫生科技项目(编号:2014A010082)

摘　　要：目的研究单臂轨道式外固定支架治疗胫骨创伤后骨缺损的中远期随访效果。方法纳入我院70例胫骨创伤后骨缺损患者为研究对象,将患者抽签随机分为观察组与对照组各35例。观察组采用单臂轨道式外固定支架治疗,对照组采用环形外固定支架治疗,随访2年,全部随访成功。比较两组骨延长长度、骨延长区域矿化时间、带架时间及骨折愈合优良率,记录改良Barthel指数量表评分、汉密顿焦虑量表(HAMA)评分、生活质量量表(SF-36)评分及并发症发生率。结果两组骨延长长度、骨延长区域矿化时间、带架时间、胫骨骨折愈合优良率比较无统计学意义(P>0.05)。观察组术后1年Barthel指数评分高于对照组,HAMA评分低于对照组(P<0.05)。观察组术后1年活力、社会功能、情感职能、精神健康评分高于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论单臂轨道式外固定支架与环形外固定支架治疗胫骨创伤后骨缺损的疗效相当,但前者能更好的缓解患者焦虑情绪,改善生活质量,提高日常生活能力,且可降低并发症发生率,具有更好的临床应用价值。Objective To study the effects of middle and long term follow - up after single track external fixator in the treatment of bone defect of tibia. Methods 70 patients with bone defect after tibial trauma in our hospital were included in this study and randomly divided into observation group and control group with 35 cases in each group. The observation group was treated with one arm external fixation, while the control group was treated with external fixator. All patients were followed up for 2 years. The length of bone lengthening, time of mineralization in bone lengthening area, shelf time and rate of fracture healing were compared between the two groups. The modified Barthel index scale and Hamilton Anxiety Scale （HAMA） score, quality of life scale （ SF -36） score and the incidence of complications were recorded. Results There were no significant differences between the two groups in the length of bone lengthening, the time of mineralization in bone lengthening area, the shelf time and the healing rate of tibial fractures （ P 〉 0. 05 ） . The Barthel index score of the observation group was higher than that of the control group after 1 year, and the HAMA score was lower than that of the control group （P 〈0. 05）. After 1 year, the vitality, social function, emotional function and mental health score of the observation group were higher than those of the control group （ P 〈 0. 05 ） . The complication rate of the observation group was lower than that of the control group （ P 〈 0. 05 ） . Conclusion Single arm external fixation and external fixator can be used for the treatment of tibi-al bone defect after trauma. The former can better relieve anxiety and improve the quality of life. It can improve the ability in daily living and reduce the incidence of complications. Single arm external fixation has better clinical application value.

关 键 词：单臂轨道式外固定支架 胫骨创伤 骨缺损 中远期效果 

分 类 号：R687.3[医药卫生—骨科学]