改良牵拉成骨技术促进胫骨延长区骨质矿化41例  

41 Cases Observation on the Effect of Modified Traction Osteogenesis Technique on Promoting Bone Mineralization in the Tibial Elongation Region

作　　者：谭新欢 王凯君 初海滨 毕宏政 杨庆民 聂伟志 宫大伟 于满秋 TAN Xinhuan;WANG Kaijun;CHU Haibin;BI Hongzheng;YANG Qingmin;NIE Weizhi;GONG Dawei;YU Manqiu(Wendeng Hospitial of Traditional Chinese Orthopedics and Traumatology of Shandong Province,Weihai 264400,Shandong China.)

机构地区：[1]山东省文登整骨医院,山东威海264400

出　　处：《中国中医骨伤科杂志》2024年第8期55-59,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：威海市中医药科技项目(2023N-39);山东省中医药科技项目(2021M062);中国中医药信息学会科研项目(CACMS-KY-2023017);杨茂清全国名老中医药专家传承工作室项目(国中医药人教函〔2022〕75号);2023年国家中医药管理局科技司-山东省卫生健康委员会共建中医药科技项目(GZY-KJS-SD-2023-030)。

摘　　要：目的:观察改良牵拉成骨技术在促进胫骨延长区骨质矿化方面的临床疗效及安全性。方法:回顾性分析2018年1月至2023年2月收治的41例开放性胫骨大段骨缺损患者的病例资料,均采用改良牵拉成骨技术治疗,骨搬移开始后每4周测量并记录延长骨段骨密度(BMD)及骨痂直径率(CDR),统计骨愈合指数及相关并发症情况,末次随访按Ilizarov技术研究与应用学会(ASAMI)骨与下肢功能评价标准进行评价。结果:41例患者均获随访,随访时间为12~18个月,平均为15.8个月;骨搬移均顺利完成,术后6例外固定支架螺钉孔周围出现少许红肿及渗出,牵拉成骨过程中出现1例轴向偏移;创面一期愈合32例,伤口愈合时间为14~24d,平均为(18.27±4.43)d;骨愈合指数为(1.208±0.124)个月/cm;术后4,8,12,16周骨密度持续增加,骨痂直径率随着骨密度的逐步增加呈现相对减小的趋势,但在固化期其逐步增大;末次随访按ASAMI骨评价,优良率为90.24%;按ASAMI下肢功能评价,优良率为85.37%。结论:改良牵拉成骨技术能加快胫骨延长骨段矿化成骨速度,提高矿化成骨的质量,减少相关并发症,有利于肢体功能的恢复。Objective:To observe the clinical efficacy and safety of improved distraction osteogenesis technique in promoting bone mineralization in tibia lengthening area.Methods:From January 2018to February 2023,41patients with open tibial defects were selected.All patients were treated with modified distraction osteogenesis,bone mineral density(BMD)and callus diameter rate(CDR)were measured and recorded every 4weeks after bone transport.Bone healing index and related complications were recorded.Results:All the 41patients were followed up for 1218months(mean 15.8months).The bone transfer was completed successfully.After operation,there were a little swelling and exudation around the screw holes of the external fixator in 6cases,the average healing time was(18.27±4.43)d,the bone healing index was(1.208±0.124)month/cm at 4,8,12and 16weeks after operation,the BMD increased continuously,and the CDR decreased with the increase of BMD,but increased gradually in the solidified stage,the excellent and good rate was 90.24%and 85.37%according to Asami's evaluation of lower extremity function.Conclusion:The modified distraction osteogenesis technique can accelerate the speed of bone mineralization,improve the quality of bone mineralization,reduce the related complications and benefit the recovery of limb function.

关 键 词：骨折 骨搬移 胫骨骨缺损 骨密度 

分 类 号：R683.42[医药卫生—骨科学]