骨搬运技术结合腓骨段植入治疗胫骨骨缺损的疗效分析  

Curative effect of bone transport combined with fibula implantation for treating large segmental tibial bone defect

作　　者：尚旭亚 童良勇[1] 张志凌[1] 潘魏巍 严惠强 李民[1] SHANG Xuya;TONG Liangyong;ZHANG Zhiling(Department of Joint Orthopedics,Second Naval Hospital of Southern War Zone,Sanya,Hainan,571000,China)

机构地区：[1]中国人民解放军南部战区海军第二医院骨二区,海南三亚571000

出　　处：《实用手外科杂志》2020年第3期269-272,共4页Journal of Practical Hand Surgery

基　　金：三亚市医疗卫生科技创新项目基金资助(编号:2015YW06)。

摘　　要：目的探讨骨搬运技术结合胫骨髓内腓骨段植入治疗下肢胫骨骨折术后感染性大段骨缺损的效果。方法纳入2013年9月-2018年9月住院的胫骨骨折术后感染性大段骨缺损患者42例,随机分成两组,各21例,一组采用单边重建外固定延长架结合胫骨髓内腓骨植入治疗,另一组采用常规单边重建外固定延长架治疗。术后对比两组的手术时间、病程、术中及术后出血量、手术次数、HHS膝关节功能评分、Baird-Jackson踝关节功能评分。结果胫骨髓内腓骨段植入组病程短、手术次数少,与不植骨组比较均有统计学意义(P<0.05)。两组患者手术时间、手术出血量比较无明显统计学差异;两组的HHS膝关节功能评分、Baird-Jackson踝关节功能评分均较术前有明显提高(P<0.01)。结论骨搬运技术治疗胫骨骨缺损的疗效佳,可较好地改善患者的膝关节和踝关节功能。其中骨搬运技术结合胫骨髓内腓骨段植入能缩短病程、减少手术次数,是治疗胫骨大段骨缺损的有效方法。Objective To explore the curative effect of bone transport combined with fibula implantation in tibial bone marrow on treating infectious large bone defect after surgery for tibial fracture.Methods Fortytwo patients with infectious large segmental bone defect after tibial fracture operation admitted to our hospital from September 2013 to September 2018 were enrolled in the study and randomly divided into two groups.Osteotomy was performed in group A by external fixing lengthening frame of unilateral reconstruction combined with fibula implantation in tibial bone marrow,and osteotomy was performed in group B by external fixing lengthening frame of unilateral reconstruction.Operation time,blood loss,bone healing time,number of operations,HHS knee function score and Baird-Jackson ankle function score were compared between groups.Results The bone graft group had a shorter course and fewer operations,and there was a statistically significant difference compared with the non-bone graft group(P<0.05).The HHS knee function score and Baird-Jackson ankle function score were significantly higher increased after surgery in all patients(P<0.01).There was no significant difference in the operation time and intraoperative blood loss between the two groups.Conclusion The bone transport technique can achieve good curative effect on infectious large segment bone defect after tibial fracture operation.It can better improve the knee and ankle joint function of the patient.Bone transport combined with fibula implantation in tibial bone marrow can shorten the course of disease and reduce the number of operations.It is an effective method for the treatment of large segmental tibial bone defect.

关 键 词：大段骨缺损 髓内植骨 骨搬运术 胫骨骨折 感染 

分 类 号：R687.3[医药卫生—骨科学]