胫神经损伤对胫骨单截骨骨搬移治疗效果的影响  

Effect of tibial nerve injury on treatment of tibial single-plane osteotomy and bone transport

作　　者：许奥 王斌[2] 方均 白崔魏 吕梓宸 程康 郑永鑫 王红涛 Xu Ao;Wang Bin;Fang Jun;Bai Cuiwei;Lyu Zichen;Cheng Kang;Zheng Yongxin;Wang Hongtao(Graduate School of North China University of Science and Technology,Tangshan 063000,Hebei Province,China;Department of Orthopedics,Tangshan Second Hospital,Tangshan 063000,Hebei Province,China;Department of Imaging,Affiliated Hospital of Qingdao Binhai University,Qingdao 266000,Shandong Province,China)

机构地区：[1]华北理工大学研究生学院,河北省唐山市063000 [2]唐山市第二医院骨科,河北省唐山市063000 [3]青岛滨海学院附属医院影像科,山东省青岛市266000

出　　处：《中国组织工程研究》2024年第12期1925-1930,共6页Chinese Journal of Tissue Engineering Research

基　　金：河北省自然科学基金项目(H2021105020),项目负责人:王斌。

摘　　要：背景:周围神经在骨代谢中扮演着重要角色,但临床上神经损伤对骨搬移技术的影响有待进一步研究。目的:探讨胫神经损伤对胫骨单截骨骨搬移手术治疗效果的影响。方法:选择2011年5月至2022年6月唐山市第二医院收治的胫骨骨缺损患者32例,根据是否合并胫神经损伤分为胫神经损伤组(n=16)与无胫神经损伤组(n=16),两组均接受单截骨骨搬移手术治疗。治疗后进行随访,观察两组患者矿化区愈合指数、外固定指数、对接点愈合及针道感染等情况;拆除外固定后,采用Ilizarov方法研究与应用协会(ASAMI)评分标准评价骨愈合和功能评价。结果与结论:①32例患者治疗后均获得随访,平均随访(25.28±4.79)个月,两组骨性愈合时间、外固定时间、愈合指数与外固定指数比较差异均无显著性意义(P>0.05);胫神经损伤组2例、无胫神经损伤组1例出现针道感染,均为PALEYⅠ度,组间比较差异无显著意义(P>0.05);胫神经损伤组对接点不愈合率为31%,无胫神经损伤组为13%,组间比较差异无显著性意义(P>0.05);两组ASAMI骨愈合评分的优良率均为100%,肢体评分优良率胫神经损伤组为81%、无胫神经损伤组为94%,组间比较差异均无显著性意义(P>0.05);②结果表明,胫神经损伤对胫骨单截骨骨搬移手术治疗的矿化速度、外固定时间、对接点愈合、针道感染、矿化区成骨质量等无明显影响。BACKGROUND:Peripheral nerves play an important role in bone metabolism.In clinical practice,the specific impact of nerve injury on bone transport technology needs further study.OBJECTIVE:To investigate the effect of tibial nerve injury on the treatment of tibial slip by single-plane osteotomy.METHODS:Thirty-two patients with tibial bone defects admitted to Tangshan Second Hospital from May 2011 to June 2022 were selected.According to the presence or absence of tibial nerve injury,patients were divided into the tibial nerve injury group(n=16)and the non-tibial nerve injury group(n=16).Both groups were treated with single-plane osteotomy and bone slip.After treatment,the patients were followed up to collect the mineralization zone healing index,external fixation index,docking point healing and needle infection.After the removal of external fixation,the bone healing and functional evaluation were evaluated by a classification of the Association for the Study and Application of the Method of Ilizarov(ASAMI).RESULTS AND CONCLUSION:(1)All 32 patients were followed up for(25.28±4.79)months.There were no significant differences in bone healing time,external fixation time,healing index and external fixation index between the two groups(P>0.05).Needle infection occurred in two cases of the tibial nerve injury group and one case of the non-tibial nerve injury group,all of which were PALEY I,and there was no significant difference between the two groups(P>0.05).The non-union rate of the occlusal end of the tibial nerve injury group was 31%,and that of the non-tibial nerve injury group was 13%;there was no statistical difference between the two groups(P>0.05).The excellent and good rate of ASAMI bone healing score in the two groups was 100%;the excellent and good rate of limb score was 81%in the tibial nerve injury group and 94%in the non-tibial nerve injury group;there was no statistical difference between the two groups(P>0.05).(2)Our research shows that tibial nerve injury has no significant effect on the mineralization s

关 键 词：胫骨骨缺损 骨搬移 ILIZAROV 牵拉成骨 胫神经损伤 神经轴索断裂 

分 类 号：R459[医药卫生—治疗学] R318[医药卫生—临床医学] R687