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采用伊里扎洛夫外固定器治疗的胫骨应力性骨折

Stress Fractures of Tibia Treated with Ilizarov External Fixator.

作者信息

Górski Radosław, Żarek Sławomir, Modzelewski Piotr, Górski Ryszard, Małdyk Paweł

机构信息

Department of Orthopaedics and Musculoskeletal Traumatology, Medical University of Warsaw, Warsaw, Poland.

出版信息

Ortop Traumatol Rehabil. 2016 Aug 30;18(4):337-347. doi: 10.5604/15093492.1220825.

Abstract

BACKGROUND

Stress fractures are the result of cyclic loading of the bone, which gradually becomes damaged. Most often they are treated by rest or plaster cast and, in rare cases, by internal fixation. There is little published data on initial reposition followed by stabilization with the Ilizarov apparatus in such fractures.

MATERIAL AND METHODS

Six patients were treated with an external fixator according to the Ilizarov method for a stress fracture of the tibia between 2007 and 2015. Three patients were initially treated conservatively. Due to increasing tibial deformation, they were qualified for surgical treatment with external stabilization. In the other patients, surgery was the first-line treatment. All patients demonstrated risk factors for a stress fracture. After the surgery, they fully loaded the operated limb.

RESULTS

No patient developed malunion, nonunion, infection or venous thrombosis. The average time from the first operation to the removal of the external fixator was 19 weeks. Radiographic and clinical outcomes were satisfactory in all patients.

CONCLUSION

  1. The Ilizarov method allows for successful stabilization of stress fractures of the tibia. 2. It may be a good alternative to internal stabilization, especially in patients with multiple comorbidities which affect bone quality and may impair soft tissue healing.
摘要

背景

应力性骨折是骨骼反复承受负荷导致逐渐受损的结果。大多数情况下,通过休息或石膏固定进行治疗,极少数情况下采用内固定治疗。关于此类骨折采用伊里扎洛夫器械进行初始复位并随后固定的已发表数据很少。

材料与方法

2007年至2015年间,6例胫骨应力性骨折患者采用伊里扎洛夫方法使用外固定器进行治疗。3例患者最初采用保守治疗。由于胫骨畸形加重,他们符合外固定手术治疗的条件。其他患者则将手术作为一线治疗方法。所有患者均表现出应力性骨折的危险因素。手术后,他们对手术肢体进行了完全负重。

结果

没有患者出现骨愈合不良、骨不连、感染或静脉血栓形成。从首次手术到拆除外固定器的平均时间为19周。所有患者的影像学和临床结果均令人满意。

结论

  1. 伊里扎洛夫方法能够成功固定胫骨应力性骨折。2. 对于内固定而言,它可能是一个很好的替代方法,尤其是对于患有多种合并症影响骨质且可能损害软组织愈合的患者。

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