Department of Orthopedic Trauma, University of Texas Health Science Center, Houston, TX.
Department of Health and Human Performance, University of Houston, Houston, TX.
J Orthop Trauma. 2018 Jun;32(6):301-305. doi: 10.1097/BOT.0000000000001141.
To evaluate the healing rate of aseptic nonunions of the distal third of the tibia treated with Ilizarov slow gradual compression and deformity correction.
Retrospective cohort study.
Tertiary referral center.
PATIENTS/PARTICIPANTS: Ninety-four consecutive adult patients with 94 distal third tibial aseptic nonunions.
Ilizarov external fixation and slow gradual compression; most patients also underwent bone grafting, deformity correction, or both before the initiation of compression.
Rate of bony union.
Eighty-seven of 94 cases (92.6%) healed after slow gradual compression across the nonunion site with a circular external fixator. Four of the 7 patients who failed treatment healed after additional operative treatment, and the remaining 3 refused further care.
Circular external fixation with slow gradual compression was successful in treating aseptic nonunions of the distal third of the tibia in 92.6% of cases. Careful selection of patients for this treatment method can lead to a high success rate with a relatively low rate of major complications.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
评估采用伊利扎罗夫缓慢渐进加压和畸形矫正治疗胫骨远端三分之一无菌性骨不连的愈合率。
回顾性队列研究。
三级转诊中心。
患者/参与者：94 例连续成人患者，共 94 例胫骨远端三分之一无菌性骨不连。
伊利扎罗夫外固定架和缓慢渐进加压；大多数患者在开始加压前还进行了植骨、畸形矫正或两者兼有。
骨性愈合率。
在使用环形外固定架缓慢渐进加压治疗后，94 例中有 87 例（92.6%）骨愈合。7 例治疗失败的患者中，有 4 例在接受额外的手术治疗后愈合，其余 3 例拒绝进一步治疗。
环形外固定架缓慢渐进加压治疗胫骨远端三分之一无菌性骨不连的成功率为 92.6%。对这种治疗方法的患者进行仔细选择，可以获得较高的成功率，且主要并发症的发生率相对较低。
治疗 IV 级。有关证据水平的完整描述，请参见作者说明。
