Department of Orthopaedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy.
Istituto di Ricovero e Cura a Carattere Scientifico IRCCS Ortopedico Galeazzi, Milan, Italy.
Med Glas (Zenica). 2021 Feb 1;18(1):287-292. doi: 10.17392/1280-21.
Aim The septic non-union is a common compliance in bone healing due to bone infection. Bone resection, associated with Ilizarov osteo-distraction technique, is commonly used in these cases. The aim of this study was to analyse clinical and radiological results of teriparatide in combination with the Ilizarov technique and to compare this treatment with the standard treatment. Methods Forty adult patients underwent surgery because of type C of the Association for the Study and Application of Methods of Ilizarov (ASAMI) classification non-union were enrolled. The patients were divided in two groups: those treated with Ilizarov technique (Norm group) and those treated with Ilizarov technique combined with teriparatide injection (Teri group). Surgical duration, complication rate, bone healing status, clinical and functional outcomes were assessed according to the A.S.A.M.I. classification in the mean follow-up of 12 months. The subjective quality of life was assessed by the Short Form Survey (SF)-12. Results Teri group showed less time wearing Ilizarov's frame (p <0.05) than the Norm group and a statistical significance in the inter-rater reliability Cohen's k (p>0.05) respect to Norm according the score between the bone healing and clinical outcome results. There was no statistically significant difference between the two groups in other parameters that were assessed. Conclusion A benefit of teriparatide was found as adjuvant in the treatment of septic non-union.
目的 由于骨感染,骨髓炎导致的骨不愈合是骨愈合中的常见并发症。在这些情况下,通常采用骨切除联合伊里扎洛夫骨牵张技术。本研究旨在分析甲状旁腺素(teriparatide)联合伊里扎洛夫技术的临床和影像学结果,并将该治疗方法与标准治疗进行比较。
方法 纳入 40 例因 ASAMI 分类 C 型骨髓炎非愈合而接受手术的成年患者。患者分为两组:接受伊里扎洛夫技术治疗(常规组)和接受伊里扎洛夫技术联合甲状旁腺素注射治疗(特立组)。在平均 12 个月的随访中,根据 A.S.A.M.I. 分类评估手术持续时间、并发症发生率、骨愈合状况、临床和功能结果。通过简短健康调查量表(SF-12)评估主观生活质量。
结果 特立组佩戴伊里扎洛夫框架的时间明显短于常规组(p<0.05),并且在骨愈合和临床结果评分方面,两组之间的评分具有较高的组内信度 Cohen's k(p>0.05)。两组在其他评估参数方面无统计学差异。
结论 甲状旁腺素作为辅助治疗骨髓炎性骨不愈合有一定益处。