轴向载荷分担比测试辅助Taylor空间支架治疗胫腓骨骨折的作用  

Effect of axial load test in assisting Taylor spatial frame for tibia and fibula fractures

作　　者：刘钊 万春友[2] 张涛[2] 王明杰 张宁宁 葛启航 曹海鲲 雍炜 赵远航 张伟业 Liu Zhao;Wan Chunyou;Zhang Tao;Wang Mingjie;Zhang Ningning;Ge Qihang;Cao Haikun;Yong Wei;Zhao Yuanhang;Zhang Weiye(Graduate School of Tianjin Medical University,Tianjin 300070,China;No.1 Ward of Limb Orthopedics,Tianjin Hospital,Tianjin 300211,China;Graduate School of Tianjin Traditional Chinese Medicine University,Tianjin 300193,China)

机构地区：[1]天津医科大学研究生院,300070 [2]天津医院矫形一病区,300211 [3]天津中医药大学研究生院,300193

出　　处：《中华创伤杂志》2019年第4期348-353,共6页Chinese Journal of Trauma

基　　金：天津市卫生局科技攻关项目(13KG129).

摘　　要：目的探讨骨外固定轴向载荷分担比测试在Taylor空间支架治疗胫腓骨骨折中的作用。方法采用回顾性病例对照研究分析2015年3月—2017年6月天津医院收治的36例开放性胫腓骨骨折患者临床资料,其中男22例,女14例;年龄21~71岁[(46.1±14.2)岁]。患者均于伤后1周内接受胫腓骨骨折Taylor空间支架外固定术。18例术后行轴向载荷分担比测试(试验组),18例未行测试(对照组)。患者术后定期门诊复查,试验组行轴向载荷分担比测试,当测试值<5%时给予拆除Taylor空间支架;对照组应用传统外固定拆除方法拆除Taylor空间支架。比较两组Taylor空间支架治疗时间、治疗总费用和拆除Taylor空间支架再骨折及针道感染等并发症发生率。结果患者均获随访3~14个月,平均8.6个月。与对照组相比,试验组治疗时间、治疗总费用明显低于对照组[治疗时间:(36.17±11.44)周∶(44.50±9.16)周;治疗总费用:(9.37±0.79)万元∶(12.01±1.06)万元](P均<0.05)。试验组术后出现再骨折0例,针道感染2例,并发症发生率为11%;对照组出现再骨折2例,针道感染3例,并发症发生率为28%(P>0.05)。结论在Taylor空间支架治疗胫腓骨骨折术后,规律应用轴向载荷分担比测试技术能够安全及时地指导Taylor空间支架拆除,与传统拆除方法相比,能够减少患者治疗时间和费用,效果安全可靠。Objective To investigate the effect of axial load test in Taylor spatial frame treatment of external fixation for tibia and fibula fractures. Methods A retrospective case-control study was conducted to analyze the clinical data of 36 patients with open fracture of tibia and fibula admitted to Tianjin Hospital from March 2015 to June 2017. There were 22 males and 14 females, aged 21-71 years [(46.1±14.2)years]. All patients received Taylor spatial frame external fixation for tibia and fibula fracture within 1 week after injury. After operation, 18 patients received axial load test (experiment group), and the other 18 did not (control group). When the value of axial load test was less than 5% in experiment group, the Taylor spatial frame was removed. The control group used traditional method to remove the Taylor spatial frame. Comparisons were made between the two groups in terms of treatment duration, total cost, re-fracture after Taylor spatial frame removal and incidence of stent-tract infection. Results All patients were followed up for 3-14 months with an average of 8.6 months. Compared with control group, the treatment duration [(36.17±11.44)weeks vs.(44.50±9.16)weeks] and total cost [(93.7±7.9)thousand yuan vs.(120.1±10.6)thousand yuan] of experiment group were significantly lower (P<0.05). In the experiment group, there was 0 patient with re-fracture and two patients with stent-tract infection, with the complication incidence of 11%, while there were two patients with re-fracture and three patients with stent-tract infection, with the complication incidence of 28% in the control group (P>0.05). Conclusions After Taylor spatial frame external fixation for tibia and fibula fractures, regular axial load test can safely and timely guide the removal of Taylor spatial frame. It can reduce the treatment duration and cost compared with the traditional removal method, being safe and reliable.

关 键 词：胫骨骨折 腓骨 外固定器 轴向载荷 

分 类 号：R687.3[医药卫生—骨科学]