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抗生素硫酸钙负载杂交输送与传统伊里扎洛夫骨搬运术治疗创伤后大段胫骨缺损的比较。

Antibiotic calcium sulfate-loaded hybrid transport versus traditional Ilizarov bone transport in the treatment of large tibial defects after trauma.

机构信息

Department of Orthopaedic Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, Shaanxi, China.

出版信息

J Orthop Surg Res. 2021 Sep 20;16(1):568. doi: 10.1186/s13018-021-02723-9.

DOI:10.1186/s13018-021-02723-9
PMID:34544458
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8454113/
Abstract

BACKGROUND

The purpose of this study was to compare the clinical effects of antibiotic calcium sulfate-loaded hybrid transport (ACSLHT) and traditional Ilizarov bone transport (TIBT) in the treatment of large tibial defects after trauma.

METHODS

Eighty-five patients with large tibial defects after trauma were selected for retrospective study. The range of tibial defects was 6-22 cm. After thorough debridement and infection controlled, bone transport technique was used to reconstruct tibial defects. Forty-four patients were treated with ACSLHT technique (the ACSLHT group), while the other 41 were treated with TIBT technique (the TIBT group). Time in external fixator was evaluated by EFI score. Enneking score was used to evaluate limb functions. SAS score was used to evaluate postoperative anxiety status. In addition, complication incidence was compared, including axis deviation, docking site nonunion, infection recurrence and so on.

RESULTS

There was no significant difference in preoperative general data between ACSLHT and TIBT group. EFI score in ACSLHT and TIBT group was 0.6 ± 0.1 cm/month and 1.7 ± 0.3 cm/month, respectively (P < 0.05). Enneking score of ACSLHT and TIBT group was 86.5% and 75.1% (P < 0.05). SAS score of ACSLHT group was significantly lower than that of TIBT group (P < 0.05). Complication incidence in ACSLHT group was significantly lower than that in TIBT group (P < 0.05).

CONCLUSIONS

Compared with TIBT group, ACSLHT group had shorter time in external fixator, better limb functions, lower postoperative anxiety score and lower complication incidence which is worth of clinical promotion.

摘要

背景

本研究旨在比较抗生素硫酸钙负载杂交转运（ACSLHT）与传统伊利扎洛夫骨搬运（TIBT）治疗创伤后大段胫骨缺损的临床效果。

方法

回顾性研究 85 例创伤后大段胫骨缺损患者，胫骨缺损范围 6-22cm。彻底清创、控制感染后，采用骨搬运技术重建胫骨缺损。44 例采用 ACSLHT 技术（ACSLHT 组）治疗，41 例采用 TIBT 技术（TIBT 组）治疗。采用 EFI 评分评估外固定器时间。采用 Enneking 评分评估肢体功能。采用 SAS 评分评估术后焦虑状况。比较两组并发症发生率，包括轴偏差、对接部位不愈合、感染复发等。

结果

ACSLHT 组与 TIBT 组术前一般资料比较差异无统计学意义。ACSLHT 组和 TIBT 组的 EFI 评分分别为 0.6±0.1cm/月和 1.7±0.3cm/月（P<0.05）。ACSLHT 组和 TIBT 组的 Enneking 评分分别为 86.5%和 75.1%（P<0.05）。ACSLHT 组的 SAS 评分明显低于 TIBT 组（P<0.05）。ACSLHT 组的并发症发生率明显低于 TIBT 组（P<0.05）。

结论

与 TIBT 组相比，ACSLHT 组外固定器时间更短，肢体功能更好，术后焦虑评分更低，并发症发生率更低，值得临床推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/e12d1cab6150/13018_2021_2723_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/c6a175030ddf/13018_2021_2723_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/378d33d7fd53/13018_2021_2723_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/6ee0fa4b17c1/13018_2021_2723_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/88adfbbcce50/13018_2021_2723_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/e12d1cab6150/13018_2021_2723_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/c6a175030ddf/13018_2021_2723_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/378d33d7fd53/13018_2021_2723_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/6ee0fa4b17c1/13018_2021_2723_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/88adfbbcce50/13018_2021_2723_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/256c/8454113/e12d1cab6150/13018_2021_2723_Fig5_HTML.jpg

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