Zhu Jia-Fu, Xu Wei-Xing, Hu Qiang, Wu Tian-Quan, Liu Hong
Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, People's Republic of China.
Department of Orthopaedics, Shaoxing Keqiao District Hospital of Traditional Chinese Medicine, Shaoxing 312030, People's Republic of China.
Ther Clin Risk Manag. 2020 Jun 23;16:559-565. doi: 10.2147/TCRM.S257336. eCollection 2020.
To investigate the effects of trapdoor-procedure-based bone harvesting and tricortical iliac bone harvesting on the iliac bone-graft donor site pain experienced by patients and their clinical effects.
A retrospective analysis was performed using the clinical data of 65 patients with tibial plateau fractures who received autologous iliac bone-supporting grafts in two hospitals between January 2014 and January 2019. The patients who received trapdoor-procedure-based bone harvesting (34 cases) were in the experimental group, and those who received tricortical iliac bone harvesting (31 cases) were in the control group. This study compared differences in iliac bone-graft donor site incision length, intraoperative blood loss, amount of bones harvested, operation time, and postoperative complications between the two bone-harvesting methods. Subsequently, it evaluated the pain experienced by the two patient groups in their iliac bone-graft donor sites and their clinical effects.
One week after surgery, the differences between the iliac bone-graft donor site pain score (measured using SF-MPQ-2) of the experimental group and the control group were not statistically different. However, 3 weeks, 5 weeks, and 3 months after surgery, the iliac bone-graft donor site pain scores of the experimental group were significantly lower than those of the control group. The iliac bone-graft donor site incision length and operation time of the experimental group were not significantly different from those of the control group. However, the iliac bone-graft donor site intraoperative blood loss, amount of bones harvested and the incidence of complications of the experimental group were significantly lower than those of the control group.
Trapdoor-procedure-based bone harvesting has lower donor site pain, intraoperative blood loss, and postoperative complications. However, for bone grafting in regions with significant bone loss, tricortical iliac bone harvesting remains the optimal option.
探讨基于活板门手术的取骨术和三皮质髂骨取骨术对患者髂骨移植供区疼痛及其临床效果的影响。
回顾性分析2014年1月至2019年1月期间在两家医院接受自体髂骨支撑移植的65例胫骨平台骨折患者的临床资料。采用基于活板门手术取骨的患者（34例）为试验组，采用三皮质髂骨取骨的患者（31例）为对照组。本研究比较了两种取骨方法在髂骨移植供区切口长度、术中出血量、取骨量、手术时间和术后并发症方面的差异。随后，评估了两组患者在髂骨移植供区的疼痛情况及其临床效果。
术后1周，试验组与对照组髂骨移植供区疼痛评分（采用SF-MPQ-2测量）差异无统计学意义。然而，术后3周、5周和3个月，试验组髂骨移植供区疼痛评分显著低于对照组。试验组髂骨移植供区切口长度和手术时间与对照组差异无统计学意义。然而，试验组髂骨移植供区术中出血量、取骨量及并发症发生率均显著低于对照组。
基于活板门手术的取骨术供区疼痛、术中出血量及术后并发症较低。然而，对于骨量严重丢失区域的骨移植，三皮质髂骨取骨术仍是最佳选择。
