Yokoyama K, Itoman M, Nakamura K, Tsukamoto T, Saita Y, Aoki S
Dept of Orthopedic Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan.
J Reconstr Microsurg. 2001 Jan;17(1):17-25. doi: 10.1055/s-2001-12684.
From 1991 to 1996, four free vascularized fibular grafts (FVFG) and four callus distraction (CD) techniques were performed for post-traumatic tibial defects at the authors' institute. They attempted to discern any differences of results between FVFGs and CDs for post-traumatic tibial defects. The mean defect length of the FVFG and CD groups were 7.3 cm and 4.6 cm, respectively (p < 0.05). They selected as contributing factors: external fixation time, complication rate, hospital charge, union rate, and functional score (Puno's criteria), in order to compare the treatment of FVFG with that of CD. The external fixation times of the FVFG and CD groups were 176 days and 261 days, respectively. One septic non-union after refracture of the grafted fibula occurred in the FVFG group. Two non-unions (50 percent) at the docking site occurred in the CD group. The mean total costs of the FVFG and CD groups were 7,398,536 yen (US $68,505) and 11,798,153 yen(US $109,242), respectively. The union rates of both groups were 75 percent and 100 percent, respectively. The mean functional scores of both groups were 69.5 and 88.8 points, respectively. The functional results of the FVFG group were as follows: one patient showed good results; one, fair; and two, poor. The functional results of the CD group were as follows: two patients showed excellent results; one, good; and one, fair. Both the costs and the functional outcomes between the two groups did not significantly differ. No clear differences between the two treatment groups could be determined. However, many more cases are needed to establish statistically significant differences between both methods.
1991年至1996年期间，作者所在机构针对创伤后胫骨缺损实施了4例游离带血管腓骨移植术（FVFG）和4例骨痂延长术（CD）。他们试图辨别FVFG和CD治疗创伤后胫骨缺损的结果差异。FVFG组和CD组的平均缺损长度分别为7.3厘米和4.6厘米（p < 0.05）。他们选取了外固定时间、并发症发生率、住院费用、骨愈合率和功能评分（普诺标准）作为影响因素，以比较FVFG与CD的治疗效果。FVFG组和CD组的外固定时间分别为176天和261天。FVFG组发生1例移植腓骨骨折后感染性骨不连。CD组在对接部位发生2例骨不连（50%）。FVFG组和CD组的平均总费用分别为7398536日元（68505美元）和11798153日元（109242美元）。两组的骨愈合率分别为75%和100%。两组的平均功能评分分别为69.5分和88.8分。FVFG组的功能结果如下：1例患者结果良好；1例，一般；2例，较差。CD组的功能结果如下：2例患者结果优秀；1例，良好；1例，一般。两组之间的费用和功能结果均无显著差异。无法确定两种治疗组之间存在明显差异。然而，需要更多病例才能确定两种方法之间具有统计学意义的差异。
