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双水平骨搬运治疗创伤后胫骨大段骨缺损:单中心16例经验

Double-level bone transport for large post-traumatic tibial bone defects: a single centre experience of sixteen cases.

作者信息

Zhang Yanlong, Wang Yong, Di Jun, Peng Aqin

机构信息

Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.

Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, 050051, Hebei, People's Republic of China.

出版信息

Int Orthop. 2018 May;42(5):1157-1164. doi: 10.1007/s00264-017-3684-y. Epub 2017 Nov 11.

Abstract

PURPOSE

The aim of this study was to evaluate the clinical and functional outcomes of patients with large post-traumatic tibial bone defects managed by double-level bone transport using the Ilizarov technique.

METHODS

We retrospectively reviewed 16 patients of 39.1 years (range, 16.0-65.0 years). The bone defects averaged 10.9 ± 3.8 cm (range: 6.0 cm-20.0 cm) after radical resection and were managed by double-level bone transport. Bone and functional results were evaluated according to the ASAMI criteria.

RESULTS

The mean duration of follow-up after frame removal was 29.5 ± 1.8 months (range, 12.0-36.0 months). All patients achieved complete union in both the regenerates and the docking site and eradication of infection. The mean bone transport time was 55.6 ± 23.7 days (range, 30.0-125.0 days). The mean external fixation time was 12.0 ± 3.9 months (range, 5.0-18.0 months), and the mean external fixation index was 1.1 ± 0.3 months/cm (rang, 0.8-2.0 months/cm). The bone results were excellent in ten patients and poor in six patients. The functional results were excellent in 12 patients and good in four patients.

CONCLUSION

Double-level bone transport is a safe, reliable, and successful method for large post-traumatic tibial bone defects. Furthermore, this technique can reduce bone transport time, time in frame, and total treatment time in one stage.

摘要

目的

本研究旨在评估采用伊利扎洛夫技术进行双平面骨搬运治疗创伤后胫骨大段骨缺损患者的临床及功能结果。

方法

我们回顾性分析了16例患者,平均年龄39.1岁(范围16.0 - 65.0岁)。根治性切除术后骨缺损平均为10.9±3.8厘米(范围6.0厘米 - 20.0厘米),采用双平面骨搬运治疗。根据ASAMI标准评估骨及功能结果。

结果

拆除外固定架后的平均随访时间为29.5±1.8个月(范围12.0 - 36.0个月)。所有患者再生骨及对接部位均实现完全愈合且感染消除。平均骨搬运时间为55.6±23.7天(范围30.0 - 125.0天)。平均外固定时间为12.0±3.9个月(范围5.0 - 18.0个月),平均外固定指数为1.1±0.3个月/厘米(范围0.8 - 2.0个月/厘米)。骨结果优10例,差6例。功能结果优12例,良4例。

结论

双平面骨搬运是治疗创伤后胫骨大段骨缺损安全、可靠且成功的方法。此外,该技术可在一个阶段减少骨搬运时间、外固定时间及总治疗时间。

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