Ilizarov骨搬移联合抗生素骨水泥促进胫骨大段骨缺损的对接点愈合  

Ilizarov bone transport combined with antibiotic bone cement promotes junction healing of large tibial bone defect

作　　者：张治博 王兆林[1] 王志刚[1] 李朋[1] 姜建浩 张锴[1] 杨淑野[1] 杜刚强[1] Zhang Zhibo;Wang Zhaolin;Wang Zhigang;Li Peng;Jiang Jianhao;Zhang Kai;Yang Shuye;Du Gangqiang(Department of Orthopedic Trauma,Binzhou Medical University Hospital,Binzhou 256603,Shandong Province,China)

机构地区：[1]滨州医学院附属医院创伤骨科,山东省滨州市256603

出　　处：《中国组织工程研究》2025年第10期2038-2043,共6页Chinese Journal of Tissue Engineering Research

基　　金：山东省医药卫生科技发展计划项目(202004070551),项目负责人:杜刚强。

摘　　要：背景:Ilizarov骨搬移治疗开放性胫骨大段骨缺损十分有效,但仍有并发症,其中对接点愈合困难是治疗难点之一。目的:探讨Ilizarov骨搬移联合抗生素骨水泥对开放性胫骨大段骨缺损术后对接点愈合的影响。方法:选择2010年8月至2022年1月滨州医学院附属医院收治的开放性胫骨大段(骨缺损> 4 cm)骨缺损患者51例,其中28例接受单纯Ilizarov骨搬移治疗(对照组),23例接受Ilizarov骨搬移联合抗生素骨水泥治疗(试验组)。统计比较两组患者外固定时间、骨愈合时间、骨愈合指数、骨搬移过程中的目测类比评分、末次随访时的骨缺损肢体功能、对接点愈合及并发症发生情况。结果与结论:(1)51例患者均获得完整随访,平均随访(22.53±5.77)个月,试验组患者外固定时间、骨愈合时间、骨愈合指数、术后感染率及对接点未愈合率均少于对照组(P <0.05),两组二期手术后6个月的目测类比评分、末次随访时的骨缺损肢体功能优良率比较差异无显著性意义(P> 0.05);(2)结果表明,相较于单纯的Ilizarov骨搬移治疗,Ilizarov骨搬移联合抗生素骨水泥治疗可促进开放性胫骨骨折对接点的愈合,提高骨愈合率。BACKGROUND:Ilizarov bone transport is very effective in the treatment of open large tibial bone defects,but there are still complications,among which the difficulty of junction healing is one of the difficult points in treatment.OBJECTIVE:To investigate the effect of Ilizarov bone transport combined with antibiotic bone cement on junction healing after operation of open large tibial bone defect.METHODS:Totally 51 patients with open large tibial bone defect(bone defect>4 cm)admitted to Binzhou Medical University Hospital from August 2010 to January 2022 were selected,of which 28 received Ilizarov bone transport alone(control group)and 23 received Ilizarov bone transport combined with antibiotic bone cement treatment(trial group).External fixation time,bone healing time,bone healing index,visual analog scale score during bone removal,bone defect limb function,junction healing and complications at the final follow-up were statistically compared between the two groups.RESULTS AND CONCLUSION:(1)All the 51 patients were followed up for a mean of(22.53±5.77)months.External fixation time,bone healing time,bone healing index,postoperative infection rate,and non-healing rate of junction were less in the trial group than those in the control group(P<0.05).There was no significant difference between the two groups in visual analog scale scores at 6 months after the second surgery and in the functional excellence and good rate of limb with bone defect at the final follow-up(P>0.05).(2)These findings indicate that compared with the Ilizarov bone transport alone,Ilizarov bone transport combined with antibiotic bone cement treatment can promote the healing of open tibial fracture junction and increase the rate of bone healing.

关 键 词：膜诱导成骨技术 骨搬移 对接点 骨愈合 胫骨开放性骨折 大段骨缺损 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学] R683.42