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低强度脉冲超声对前臂骨缩短术后截骨部位骨愈合的影响。

Effect of low-intensity pulsed ultrasound on bone healing at osteotomy sites after forearm bone shortening.

作者信息

Urita Atsushi, Iwasaki Norimasa, Kondo Makoto, Nishio Yasuhiko, Kamishima Tamotsu, Minami Akio

机构信息

Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

J Hand Surg Am. 2013 Mar;38(3):498-503. doi: 10.1016/j.jhsa.2012.11.032. Epub 2013 Feb 1.

DOI:10.1016/j.jhsa.2012.11.032
PMID:23375786
Abstract

PURPOSE

To test the hypothesis that low-intensity pulsed ultrasound (LIPUS) may accelerate healing at osteotomy sites after forearm bone shortening osteotomies.

METHODS

In this prospective study, we enrolled 27 patients who underwent ulnar shortening osteotomy for ulnar impaction syndrome or radial shortening osteotomy for Kienböck disease. We randomized limbs to be treated with LIPUS (14 osteotomies, LIPUS group) or without LIPUS (13 osteotomies, control group). At 1 week postoperatively, patients in the LIPUS group received once-daily 20-minute LIPUS treatments that continued until at least 12 weeks postoperatively. At 2, 4, 6, 8, 12, 16, and 24 weeks postoperatively, we assessed union of the osteotomy site to determine the time to union using 4 projections of x-rays.

RESULTS

In this study, all osteotomies achieved complete union. The mean times to complete cortical union were 57 days in the LIPUS group and 76 days in the control group. Regarding endosteal union, the mean times were 121 days in the LIPUS group and 148 days in the control group. The LIPUS group had significantly reduced times for both types of union.

CONCLUSIONS

Application of LIPUS shortened the time to cortical union by 27%, and to endosteal union by 18%. Our results indicate that LIPUS accelerated bone healing after we performed forearm bone shortening osteotomies. This may provide earlier return to activity and work for patients undergoing forearm osteotomies.

摘要

目的

验证低强度脉冲超声(LIPUS)可能加速前臂骨缩短截骨术后截骨部位愈合的假说。

方法

在这项前瞻性研究中,我们纳入了27例因尺骨撞击综合征接受尺骨缩短截骨术或因月骨无菌性坏死接受桡骨缩短截骨术的患者。我们将肢体随机分为接受LIPUS治疗的组(14例截骨术,LIPUS组)和不接受LIPUS治疗的组(13例截骨术,对照组)。术后1周,LIPUS组患者每天接受一次20分钟的LIPUS治疗,持续至术后至少12周。在术后2、4、6、8、12、16和24周,我们通过4个X线投照评估截骨部位的愈合情况,以确定愈合时间。

结果

在本研究中,所有截骨均实现了完全愈合。LIPUS组皮质骨完全愈合的平均时间为57天,对照组为76天。关于骨内膜愈合,LIPUS组的平均时间为121天,对照组为148天。LIPUS组两种类型愈合的时间均显著缩短。

结论

应用LIPUS使皮质骨愈合时间缩短了27%,骨内膜愈合时间缩短了18%。我们的结果表明,LIPUS加速了前臂骨缩短截骨术后的骨愈合。这可能使接受前臂截骨术的患者更早恢复活动和工作。

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