Kenwright J, Richardson J B, Goodship A E, Evans M, Kelly D J, Spriggins A J, Newman J H, Burrough S J, Harris J D, Rowley D I
Lancet. 1986 Nov 22;2(8517):1185-7. doi: 10.1016/s0140-6736(86)92196-3.
The preliminary results are presented from a study in which 85 serious tibial fractures were treated with external skeletal fixation. In group I patients were treated with highly rigid fixation. In group II the same fixation was used but axial micromovement was applied across the fracture site for 30 min per day, starting 1-3 weeks after injury and continuing until partial weight-bearing, which leads to self-induced movement. The overall mean time to independent weight-bearing was longer in group I than group II (p = 0.02); delayed union occurred in more group I patients. Objective measurement of fracture stiffness was made by means of strain gauges placed on the fixation frame for 49 fractures treated consecutively. The time to reach stiffness levels equivalent to clinical union was significantly longer in group I than in group II. The fractures in the treatment groups were of comparable severity. It seems that the fracture healing process is susceptible to small changes in mechanical environment.
本文呈现了一项针对85例严重胫骨骨折患者采用外骨骼固定治疗的研究初步结果。在第一组中，患者接受高刚度固定治疗。在第二组中，采用相同的固定方式，但在受伤后1 - 3周开始，每天在骨折部位施加轴向微动30分钟，持续至部分负重，这会导致骨折部位自行移动。第一组患者实现独立负重的总体平均时间比第二组长（p = 0.02）；第一组中出现延迟愈合的患者更多。对于连续治疗的49例骨折患者，通过放置在固定架上的应变仪对骨折刚度进行了客观测量。第一组达到与临床愈合相当的刚度水平所需时间显著长于第二组。两个治疗组的骨折严重程度相当。似乎骨折愈合过程对力学环境的微小变化很敏感。
