三种截骨方式对胫骨骨搬移术愈合的影响分析  

Three osteotomy methods and bone healing in Ilizarov tibial bone transport

作　　者：吕梓宸 王斌[1] 高顺红[1] 刘会仁[1] 涂振兴 方均 Lyu Zichen;Wang Bin;Gao Shunhong;Liu Huiren;Tu Zhenxing;Fang Jun(Department of Hand Surgery,Tangshan Second Hospital Affiliated Orthopaedic Hospital of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]唐山市第二医院(华北理工大学附属骨科医院)手外科,唐山063000

出　　处：《中华创伤骨科杂志》2022年第4期339-344,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨三种截骨方式对胫骨Ilizarov骨搬移术愈合指数的影响。方法回顾性研究2003年12月至2019年4月唐山市第二医院手外科行胫骨Ilizarov单段骨搬移术治疗的93例患者资料。根据术中截骨方式的不同分为3组:微创截骨组16例, 全部为男性;年龄(37.1±8.3)岁;Gustilo分型:Ⅱ型5例, Ⅲ型11例。骨膜下截骨组57例, 男47例, 女10例;年龄(39.1±11.8)岁;Gustilo分型:Ⅱ型17例, Ⅲ型40例。骨膜外截骨组20例, 男19例, 女1例;年龄(37.7±11.2)岁;Gustilo分型:Ⅱ型18例, Ⅲ型2例。比较三组患者愈合指数及Ilizarov方法与应用协会(ASAMI)的功能评分。结果 3组患者术前一般资料比较差异均无统计学意义(P>0.05), 具有可比性。所有患者术后随访19~50个月(平均27.4个月)。所有患者均获骨性愈合, 相关并发症均经过相应处理后治愈。微创截骨组、骨膜下截骨组、骨膜外截骨组的愈合指数分别为(53.09±21.88)、(59.97±33.29)、(46.20±14.11)d/cm, 组间比较差异均无统计学意义(P=0.168)。3组的ASAMI评分优良率分别为87.5%、89.5%、90.0%, 组间比较差异均无统计学意义(P>0.05)。结论三种截骨方式均可获得良好的骨性愈合, 三种截骨方式的愈合指数及术后功能评分无明显差异。Objective To explore the effects of 3 osteotomy methods on the bone healing in Ilizarov tibial bone transport.Methods The data of 93 patients were retrospectively reviewed who had been treated by Ilizarov single-segment tibial bone transport at Department of Hand Surgery,The Second Hospital of Tangshan from December 2003 to April 2019.Minimally invasive osteotomy was performed in 16 patients[group A:16 males with an age of(37.1±8.3)years;5 cases of typeⅡand 11 ones of typeⅢby Gustilo classification],subperiosteal saw osteotomy in 57 patients[group B:47 males and 10 females with an age of(39.1±11.8)years;17 cases of typeⅡand 40 ones of typeⅢby Gustilo classification]and extraperiosteal wire saw osteotomy in 20 patients[group C:19 males and one female with an age of(37.7±11.2)years;18 cases of typeⅡand 2 cases of typeⅢby Gustilo classification].The 3 groups were compared in terms of the bone healing index and the Association for the Study and Application of the Method of Ilizarov(ASAMI)functional scores.Results The 3 groups were comparable because there was no significant difference in the preoperative general data between them(P>0.05).All the patients were followed up for 19 to 50 months(average,27.4 months).All patients achieved bony healing,and their associated complications were cured after corresponding treatments.There were no significant differences in the bone healing index between the 3 groups[(53.09±21.88)d/cm for group A,(59.97±33.29)d/cm for group B and(46.20±14.11)d/cm for group C](P>0.05).There were no significant differences either in the good to excellent rate by the ASAMI functional scores between the 3 groups(87.5%for group A,89.5%for group B and 90.0%for group C)(P>0.05).Conclusion All the 3 osteotomy methods may achieve good bony union,leading to similar bone healing indexes and postoperative functional scores.

关 键 词：伊利扎罗夫技术 截骨术 胫骨 骨搬移 截骨方式 骨愈合指数 

分 类 号：R687.3[医药卫生—骨科学]