Wang Jing-shuang, Hu Si-bin, Sun Hong-hui, Zheng Ji-hui, Zhao Jun-fu, Liu Dao-kuo, Lin Liang, Deng Hai-fenz, Zhang Yong-bo
Zhongguo Gu Shang. 2016 Jan;29(1):73-6.
To observe the incidence, causes and deviation angle of axial offset in patients with fracture ununited treated by Ilizarov bone transport technology.
From January 2007 to December 2012, 10 patients with fracture ununited were treated by Ilizarov bone transport including 8 males and 2 females with an average age of (30.3 ± 10.6) years old ranging from 18 to 49 years old. The segment of bone defect involved upper tibial in 2 cases, medial tibia in 2 cases, lower tibial in 5 cases, upper femoral in 1 case. For Paley type of bone defect, 6 cases were type B1, 4 cases were B3. The incidence and deviation angle of axial offset after Ilizarov bone transport technology were observed and evaluated on bone result by Paley assessment.
All patients were followed up from 19 to 32 months with an average of (22.0 ± 5.6) months. Three cases were natural healed at fracture ends, the other 7 cases were healed after bone graft. The time of external fixator was 16 to 28 months. At the last follow-up, there were 3 cases occurred coronal angulation of angle 5° to 11° with an average of (8.7 ± 3.2). Sagittal angulation was in 4 cases, angle 6° to 9° with an average of (8.5 ± 2.1)°. There were 4 cases occurred axial offset. In the last follow-up, according to Paley evaluation criteria, osseous results were excellent in 7 cases, good in 3 cases; functional results were excellent in 6 cases, good in 4 cases.
Axial deviation after the Ilizarov bone transport treatment is relatively common, which will result in delayed healing of bone and poor limb alignment. In order to improve the bone healing, corresponding measurements should be taken to avoid or reduce the incidence of axial deviation during and after the operation.
观察采用伊里扎洛夫骨搬运技术治疗骨折不愈合患者的轴向偏移发生率、原因及偏移角度。
2007年1月至2012年12月,采用伊里扎洛夫骨搬运技术治疗10例骨折不愈合患者,其中男8例,女2例,平均年龄(30.3±10.6)岁,年龄范围18~49岁。骨缺损节段:胫骨上段2例,胫骨中段2例,胫骨下段5例,股骨上段1例。Paley骨缺损类型:B1型6例,B3型4例。观察伊里扎洛夫骨搬运技术后轴向偏移的发生率及偏移角度,并依据Paley评估标准对骨愈合结果进行评价。
所有患者均获随访,随访时间19~32个月,平均(22.0±5.6)个月。骨折端自然愈合3例,其余7例经植骨后愈合。外固定器固定时间16~28个月。末次随访时,发生冠状面成角3例,角度5°~11°,平均(8.7±3.2)°;矢状面成角4例,角度6°~9°,平均(8.5±2.1)°。发生轴向偏移4例。末次随访时,根据Paley评估标准,骨愈合结果:优7例,良3例;功能结果:优6例,良4例。
伊里扎洛夫骨搬运治疗后轴向偏移较为常见,会导致骨愈合延迟及肢体对线不良。为提高骨愈合质量,术中及术后应采取相应措施避免或减少轴向偏移的发生。