Taylor空间支架外固定治疗胫骨干开放骨折术后早期与晚期部分负重的对比研究  

A comparative study of clinical efficacy between early and late partial weight-bearing after taylor spatial frame external fixation for open tibial shaft fracture

作　　者：赵启军 张涛[3] 孙逊 刘钊 张宁宁[3] 梅晓龙[3] 贾鹏[3] 姚辉[3] 徐卫国[3] Zhao Qijun;Zhang Tao;Sun Xun;Liu Zhao;Zhang Ningning;Mei Xiaolong;Jia Peng;Yao Hui;Xu Weiguo(Clinical Colledge of Orthopedics,Tianjin Medical University,Tianjin 300211,China;Department of Orthopedics,Sinopharm North Hospital,Baotou 014030,China;Department of Orthopaedics Ward One,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津医科大学骨科临床学院,天津300211 [2]国药北方医院骨科,包头014030 [3]天津市天津医院矫形一病区,天津300211

出　　处：《中华生物医学工程杂志》2023年第5期531-536,共6页Chinese Journal of Biomedical Engineering

基　　金：天津市科技计划项目(20JCZDJC00600);天津市科技计划项目(22JCQNJC00360);天津市卫生健康科技青年项目(TJWJ2023QN050)。

摘　　要：目的对比分析Taylor空间支架(TSF)外固定治疗胫骨干开放骨折患者术后早期部分负重与晚期部分负重的临床疗效。方法回顾性分析2018年1月至2020年6月在天津医院矫形一病区接受TSF治疗胫骨干开放骨折患者63例,依据术后开始部分负重时间的不同分为早期负重组(术后6周)和晚期负重组(术后10周)。终末随访时采用Johner-Wruhs胫骨干骨折疗效评定标准患肢功能。记录并比较两组患者TSF外架带架时间、完全负重时间及并发症发生情况。结果两组患者最终均骨折愈合,终末随访时早期负重组患肢功能优良率高于晚期负重组(83.33%比69.7%,Z=-2.072,P=0.038)。早期负重组TSF外架带架时间、完全负重时间均较晚期负重组短(均P<0.05)。结论与晚期部分负重相比,TSF外固定治疗胫骨干开放骨折患者术后早期、规律、持续、适度的部分负重能够促进骨折愈合,减少患者带架时间,有利于患肢机能快速恢复,具有临床应用价值及指导意义。Objective This study aims to compare and analyze the clinical efficacy of early versus late partial weight-bearing in patients undergoing Taylor Spatial Frame(TSF)external fixation for open tibial shaft fracture.Methods 63 patients with open tibial shaft fractures treated with TSF between January 2018 and June 2020 in the Department of Orthopaedics Ward One of Tianjin Hospital were retrospectively studied.Based on the timing of initiating postoperative partial weight-bearing(PWB),the patients were classified as the early weight-bearing group initiating PWB at 6 weeks postoperative and the late weight-bearing group initiating at 10 weeks postoperative.The limb function was evaluated using Johner and Wruh’s Criteria during the final follow-up.The duration of TSF application,time to full weight-bearing,and occurrence of complications were recorded and compared between the two groups.Results Both groups achieved fracture union.At the final follow-up,the early weight-bearing group exhibited a good-to-excellent rate of 83.33%,while the late weight-bearing group showed a good-to-excellent rate of 69.7%,suggesting a statistically significant difference between the two groups(Z=-2.072,P=0.038).The early weight-bearing group had a shorter duration of TSF application and time to full weight-bearing compared with the late weight-bearing group,indicating statistically significant differences between the two groups(all P<0.05).Conclusion Compared with late PWB,early,regular,continuous,and moderate PWB after TSF external fixation in patients with open tibial shaft fracture can promote fracture healing,reduce the duration of external fixation device usage,facilitate rapid functional recovery of the affected limb,thereby exhibiting clinical application value and guiding significance.

关 键 词：胫骨干开放骨折 骨折外固定 Taylor空间支架 早期部分负重 晚期部分负重 

分 类 号：R687.3[医药卫生—骨科学]