骨搬运联合植骨内固定技术与单纯骨搬运技术治疗下肢创伤后大段骨缺损的疗效比较  

Comparison of bone transport technique combined with bone grafting plus internal fixation versus simple bone transport technique for large segmental bone defects at lower limbs after trauma

作　　者：姬帅 马腾[1] 王谦[1] 李明[1] 任程[1] 戚鸿飞 崔玉 杨彦玲[2] 黄强[1] 张堃[1] 李忠[1] Ji Shuai;Ma Teng;Wang Qian;Li Ming;Ren Cheng;Qi Hongfei;Cui Yu;Yang Yanling;Huang Qiang;Zhang Kun;Li Zhong(Department of Trauma Orthopaedics,Honghui Hospital Affiliated to Medicine College,Xi'an Jiaotong University,Xi'an 710054,China;Medical College,Yan'an University,Yan'an 716000,China)

机构地区：[1]西安交通大学医学院附属红会医院创伤骨科,西安710054 [2]延安大学医学院,延安716000

出　　处：《中华创伤骨科杂志》2023年第5期446-451,共6页Chinese Journal of Orthopaedic Trauma

基　　金：陕西省自然科学基金(2022JQ-757,2022JQ-299)。

摘　　要：目的比较骨搬运联合植骨内固定技术与单纯骨搬运技术治疗下肢创伤后大段骨缺损的疗效。方法回顾性分析2015年9月至2019年9月西安交通大学医学院附属红会医院创伤骨科收治的42例下肢创伤后大段骨缺损患者资料。根据骨缺损修复方式不同分为2组:A组18例(采用骨搬运联合植骨内固定技术治疗),男11例,女7例;年龄为(35.2±10.3)岁;胫骨缺损12例,股骨缺损6例。B组24例(采用单纯骨搬运技术治疗),男15例,女9例;年龄为(37.3±9.4)岁;胫骨缺损17例,股骨缺损7例。记录并比较两组患者的外固定支架固定时间(EFT)、外固定指数(EFI)、总治疗时间及并发症发生情况。末次随访时采用Ennecking评分肢体功能恢复率(得分/总分30分)、焦虑自评量表(SAS)评分分别评估肢体功能的恢复情况和术后焦虑情况。结果两组患者术前一般资料及随访时间的比较差异均无统计学意义(P>0.05),具有可比性。两组患者手术次数的比较差异无统计学意义(P>0.05)。A组患者的EFT[(5.9±1.5)个月]、EFI[(0.45±0.09)月/cm]、总治疗时间[(16.2±2.4)个月]、Ennecking评分肢体功能恢复率(87.0%±8.6%)、SAS评分[(43.2±9.0)分]、人均并发症次数[(0.4±0.2)次/例]均显著优于B组患者[(15.3±4.2)个月、(1.19±0.28)月/cm、(19.7±3.5)个月、(77.3%±9.2%)、(58.2±9.3)分、(1.2±0.5)次/例],差异均有统计学意义(P<0.05)。讨论与单纯骨搬运技术相比,骨搬运联合植骨内固定技术治疗下肢大段骨缺损具有外架固定时间和总体治疗时间短、并发症发生率低及肢体功能恢复好等优点。Objective To compare the clinical efficacy between bone transport technique combined with bone grafting plus internal fixation and simple bone transport technique in the treatment of large segmental bone defects at lower limbs after trauma.Methods A retrospective study was conducted to analyze the clinical data of 42 patients with large segmental bone defects at lower limbs after trauma who had been treated at Department of Trauma Orthopaedics,Honghui Hospital Affiliated to Medicine College,Xi'an Jiaotong University from September 2015 to September 2019.The patients were divided into 2 groups according to the different methods of repairing bone defects.In group A of 18 patients subjected to bone transport combined with bone grafting plus internal fixation,there were 11 males and 7 females with an age of(35.2±10.3)years,and 12 tibial defects and 6 femoral defects;in group B of 24 patients subjected to simple bone transport,there were 15 males and 9 females with an age of(37.3±9.4)years,and 17 tibial defects and 7 femoral defects.The external fixation time(EFT),external fixation index(EFI),total cure time and complications were recorded and compared between the 2 groups.At the last follow-up,the Ennecking score for limb functional recovery(score/total score 30)and Self-rating Anxiety Scale(SAS)were used to evaluate respectively the functional recovery of the limbs and postoperative anxiety.Results The 2 groups were comparable because there was no significant difference between them in preoperative general data or follow-up time(P>0.05).There was no statistically significant difference in the number of surgeries between the 2 groups(P>0.05).The EFT[(5.9±1.5)months],EFI[(0.45±0.09)months/cm],total treatment time[(16.2±2.4)months],Ennecking score for limb functional recovery(87.0%±8.6%),SAS score[(43.2±9.0)points],and complications per capita[(0.4±0.2)times/case]in group A were significantly better than those in group B[(15.3±4.2)months,(1.19±0.28)months/cm,(19.7±3.5)months,(77.3%±9.2%),(58.2±9.3)points,a

关 键 词：下肢骨 骨延长术 骨折固定术 内 骨缺损 植骨 

分 类 号：R687.3[医药卫生—骨科学]