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犬牵张成骨术后骨愈合及外固定的持续时间

Durations of bone consolidation and external fixation after distraction osteogenesis in dogs.

作者信息

Tuohy Joanne L, Marcellin-Little Denis J, Griffith Emily H

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.

出版信息

Vet Surg. 2014 Nov;43(8):903-11. doi: 10.1111/j.1532-950X.2014.12189.x. Epub 2014 Apr 22.

Abstract

OBJECTIVE

To evaluate the influence of epidemiologic, surgical, and mechanical factors on the durations of bone consolidation and external fixation after distraction osteogenesis in dogs.

STUDY DESIGN

Retrospective cohort study.

SAMPLE POPULATION

Dogs (n = 115) that had corrective osteotomy with circular external fixation (CEF; n = 152) METHODS: Medical and radiographic records (1992-2012) of dogs that had corrective osteotomies were reviewed. Putative variables included age, weight, gender, and breed. Surgery date, delay before distraction, rate and duration of distraction, mechanical complications, and frame removal date were recorded. Radiographic data included bone operated, bone length, osteotomy site, bone and limb size at osteotomy site, distraction distance, and CEF frame size and stiffness.

RESULTS

Mean ± SD bone consolidation period was 56 ± 33 days. Mean duration of external fixation was 77 ± 35 days. Twelve fixation failures occurred. Radii healed faster than tibiae (P < .001). Failure of fixation (P = .002) and stiff frames (P = .033) increased duration of bone consolidation. For the tibia, durations of bone consolidation and external fixation decreased with larger bone size relative to limb size (P = .004). For the radius, bone consolidation duration decreased as distraction amount increased (P = .03).

CONCLUSION

Radii healed faster than tibiae. Wearing frames with low or moderate stiffness, the absence of mechanical complications, a larger distraction distance, and a larger bone size accelerated bone consolidation. Optimizing these factors should accelerate bone consolidation and reduce the duration of external fixation.

摘要

目的

评估流行病学、手术及机械因素对犬只牵张成骨术后骨愈合及外固定时间的影响。

研究设计

回顾性队列研究。

样本群体

接受环形外固定矫正截骨术的犬只(n = 115),共进行了152次矫正截骨术。

方法

回顾1992年至2012年接受矫正截骨术犬只的医学及影像学记录。假定变量包括年龄、体重、性别及品种。记录手术日期、牵张前延迟时间、牵张速率及持续时间、机械并发症及拆除外固定架日期。影像学数据包括手术骨骼、骨长度、截骨部位、截骨部位的骨骼及肢体尺寸、牵张距离以及环形外固定架尺寸和刚度。

结果

平均骨愈合期为56 ± 33天。平均外固定时间为77 ± 35天。发生了12次固定失败。桡骨愈合快于胫骨(P < 0.001)。固定失败(P = 0.002)及外固定架僵硬(P = 0.033)会延长骨愈合时间。对于胫骨,相对于肢体尺寸,骨骼尺寸越大,骨愈合及外固定时间越短(P = 0.004)。对于桡骨,随着牵张量增加,骨愈合时间缩短(P = 0.03)。

结论

桡骨愈合快于胫骨。使用低或中等刚度的外固定架、无机械并发症、较大的牵张距离及较大的骨骼尺寸可加速骨愈合。优化这些因素应能加速骨愈合并缩短外固定时间。

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