混合与环形外固定架治疗胫骨骨缺损的轴向偏移比较  

Comparison of Axial Deviation Between Hybrid and Circular Frame for Tibial Bone Defect

作　　者：郭学德[1] 孟红亚 万德余[1] 崔冠军 Guo Xuede;Meng Hongya;Wan Deyu(Department of Orthopedicsand Traumatology,The People's Hospital of Bozhou,Bozhou 236800,China)

机构地区：[1]安徽省亳州市人民医院创伤骨科,安徽亳州236800

出　　处：《实用骨科杂志》2021年第5期405-408,共4页Journal of Practical Orthopaedics

摘　　要：目的比较混合外固定架与环形外固定架骨搬移治疗胫骨骨缺损的轴向偏移。方法回顾观察2013年5月至2019年8月本院骨搬移治疗的48例胫骨骨缺损患者资料,25例采用混合外固定架治疗(混合组),23例采用环形外固定架治疗(环形组)。混合组男18例,女7例;年龄28~73岁,平均(48.64±10.55)岁;平均病程(19.44±16.41)个月;清创后平均骨缺损长度(7.48±2.39)cm。环形组男18例,女5例;年龄25~66岁,平均(47.22±9.24)岁;平均病程(18.52±10.04)个月;清创后平均骨缺损长度(7.78±2.31)cm。比较两组患者术后、骨残端临会合时(两骨残端间距0.5cm左右时)的轴向成角和轴向偏移发生率,以及外固定指数、骨愈合时间、针道松动发生率、骨性结果和功能结果等。结果48例患者均获得随访,随访时间16~32个月,平均随访(23.21±4.43)个月。术后混合组和环形组均无轴向偏移,轴向成角差异无统计学意义(P>0.05);临会合时混合组轴向偏移和轴向成角均低于环形组(P<0.05)。环形组针道松动发生率高于混合组,两组外固定指数、骨愈合时间、骨性结果、功能结果和针道感染率差异无统计学意义(P>0.05)。结论相较于环形外固定架而言,混合外固定架能更好地预防胫骨骨搬移过程中轴向偏移的发生。Objective To compare the axial deviation between hybrid and circular frame for tibial bone defect.Methods From May 2013 to August 2019,forty-eight cases of tibial bone defect were treated by bone transport in our hospital.Among them,25 cases were fixed with hybrid frames(hybrid group),and 23 cases were fixed with circular frames(circular group).In the hybrid group,there were 18 males and 7 females,with an average age of(48.64±10.55)years(range,28~73 years),and an average course of disease of(19.44±16.41)months and length of bone defect of(7.48±2.39)cm.In the circular group,there were 18 males and 5 females,with an average age of(47.22±9.24)years(range,25~66 years),and an average course of disease of(18.52±10.04)months and length of bone defect of(7.78±2.31)cm.The axial angulation and incidence of axial deviation were compared between the two groups after operation and at the time of bone stumps were close to contact,and the external fixation index,bone healing time,incidence of pin loosening,bony results,and functional results were compared.Results All the patients were followed up for 16~32 months,with an average of(23.21±4.43)months.After operation,there was no axial deviation in both groups,and the axial angulation had no significant difference between the two groups(P>0.05).At the time of bone stumps were close to contact,the incidence of axial deviation and axial angulation in the hybrid group were lower than those of the circular group(P<0.05).The incidence of pin loosening in the circular group was higher than that of the hybrid group(P<0.05).There were no significant difference in the external fixation index,bone healing time,bony results,functional results,and rate of pin tract infection between the two groups(P>0.05).Conclusion Compared with the circular frame,the hybrid frame can better prevent the occurrence of axial deviation in the process of tibial bone transport.

关 键 词：ILIZAROV技术 轴向偏移 骨搬移 骨缺损 

分 类 号：R687.3[医药卫生—骨科学]