发散式冲击波促进胫骨骨折术后愈合效果的观察  

Efficacy of radial shock wave therapy for promoting healing of tibial fracture after operation

作　　者：王兴龙[1] 陈辉[1] 马东印[1] 周自广[1] Wang Xinglong;Chen Hui;Ma Dongyin(Zhou Ziguang. Department of Orthopedics, Beijing Pinggu Hospital, Beijing 101200, China)

机构地区：[1]北京市平谷区医院关节外科-创伤骨科

出　　处：《感染．炎症．修复》2019年第1期36-40,F0002,共6页Infection Inflammation Repair

基　　金：北京市平谷区医院科研基金(pgyy2014B-12)

摘　　要：目的:探讨早期发散式冲击波治疗对促进胫骨骨折术后愈合的效果。方法:2014年1月1日-2017年9月30日在北京市平谷区医院行胫骨骨折固定手术的患者78例,按照手术先后顺序的单双数分为两组,研究组中不愿接受冲击波治疗的患者调整到对照组。研究组32例于术后4周开始应用冲击波治疗以促进骨折愈合,对照组46例术后进行常规治疗、功能练习,不应用冲击波治疗。比较两组患者的愈合时间、愈合率、并发症、Johner-Wruhs功能评分等。结果:研究组无一例不愈合发生,无严重并发症发生。对照组有2例不愈合、10例延迟愈合发生。研究组愈合时间小于对照组,在术后3个月、6个月骨折愈合率,术后功能方面高于对照组,差异有显著统计学意义(P<0.05)。结论:对胫骨骨折患者进行早期发散式冲击波治疗能明显缩短骨折的愈合时间,显著降低骨折延迟愈合和不愈合的发生率,是一种安全有效的促进骨折愈合的新方法。Objective: To explore the efficacy of radial shock wave therapy (RSWT) for healing of tibial fracture after operation. Methods: Seven-eight patients undergoing the surgery for tibial fracture admitted to Beijing Pinggu Hospital form Jan. 1st 2014 to Sep. 30th 2017 were divided into two groups according to the sequence of operation and patient’ wish. Thirty -two patients in the study group received RSWT 4 weeks after operation to promote fracture healing, while the 46 patients in the control group received routine treatment and functional exercises after operation, without shockwave therapy. The healing time, healing rate, complications and Johner-Wruhs functional score were recorded. Results: There was no serious complications such as nonunion or delayed union occurred in the study group, but there were 2 cases of nonunion and 10 cases of delayed union in the control group. The healing time of the study group was shorter than that of the control group (14 weeks vs. 16 weeks). The healing rate of the study group 3 months (62.5% vs. 26.1%) and 6 months (100.0 vs. 78.3%) after treatment and function 6 months after treatment ( the excellent and good outcome rate of Jonher-Wuchs scores: 93.8% vs.76.1%) were higher than those of the control group, with significant statistical differences (P < 0.05). Conclusions: RSWT can significantly shorten the healing time of tibial fractures and reduce the incidence of nonunion and delayed union. It is a saf e and effective method for promoting fracture healing.

关 键 词：发散式冲击波疗法 胫骨 骨折 骨折不愈合 骨折延迟愈合 

分 类 号：R658[医药卫生—外科学]