Department of Orthopedics and Musculoskeletal Traumatology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
Department and Clinic of Orthopaedic and Traumatologic Surgery, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
Sci Rep. 2020 Nov 25;10(1):20511. doi: 10.1038/s41598-020-77569-y.
Nonunions of the tibia, particularly those located in the distal third of the bone, are relatively common in clinical practice. There is no gold standard for the treatment of nonunions of the tibia. The purpose of our study was to assess the results of treatment with the Ilizarov method in patients with aseptic nonunions of the tibia, depending on the employed treatment strategies and surgical techniques. A total of 75 patients with Ilizarov treatment of aseptic nonunions of the tibia were evaluated in the study. The patients's mean age at the beginning of treatment was 46 years. The mean follow-up period was 10 years and 11 months. The evaluated patients underwent either closed technique or open technique. The operators used one of two treatment strategies: neutral fixation without compression or continued compression. The following were assessed: rates of union, ASAMI bone scores, ASAMI functional scores, treatment time, complications, duration of hospital stay. Bone union was achieved in all of the 75 evaluated patients. The results of most analyses showed no significant differences in the assessed variables, except for the ASAMI functional scores, which were higher in the group of patients who underwent closed surgery (Me = 6.00 vs. Me = 4.00). We observed better ASAMI functional score outcomes in the patients who underwent closed fixation than in the open fixation group. The different surgical techniques and treatment strategies had no effect on the number of complications, rates of bone union, length of hospital stay, duration of Ilizarov treatment, or ASAMI bone scores. For managing nonunions of the tibia we recommend the technique of closed fixation without continued compression. The Ilizarov method in the treatment of nonunions of the tibia gives good outcomes.
胫骨骨不连，尤其是位于骨的远三分之一处的骨不连，在临床实践中较为常见。胫骨骨不连的治疗没有金标准。我们的研究目的是评估伊里扎洛夫（Ilizarov）方法治疗非感染性胫骨骨不连的结果，取决于所采用的治疗策略和手术技术。共有 75 例接受伊里扎洛夫治疗的非感染性胫骨骨不连患者在研究中进行了评估。患者治疗开始时的平均年龄为 46 岁。平均随访时间为 10 年 11 个月。评估的患者接受了闭合技术或开放技术。手术医生使用了两种治疗策略之一：无加压的中性固定或持续加压。评估了以下内容：愈合率、ASAMI 骨评分、ASAMI 功能评分、治疗时间、并发症、住院时间。在评估的 75 例患者中，所有患者均实现了骨愈合。除 ASAMI 功能评分外，大多数分析的结果在评估变量中没有显著差异，接受闭合手术的患者的 ASAMI 功能评分更高（中位数为 6.00 比中位数为 4.00）。与接受开放固定的患者相比，接受闭合固定的患者的 ASAMI 功能评分结果更好。不同的手术技术和治疗策略对并发症数量、骨愈合率、住院时间、伊里扎洛夫治疗持续时间或 ASAMI 骨评分均无影响。对于管理胫骨骨不连，我们建议采用无持续加压的闭合固定技术。伊里扎洛夫（Ilizarov）方法治疗胫骨骨不连可获得良好的结果。
