Bafor Anirejuoritse, Duncan Molly E, Iobst Christopher A
Department of Orthopedics, Nationwide Children's Hospital, Columbus, Ohio, United States of America.
Strategies Trauma Limb Reconstr. 2022 Sep-Dec;17(3):148-152. doi: 10.5005/jp-journals-10080-1572.
Limb lengthening is increasingly accomplished by internal lengthening nails. Previous versions of the magnetic lengthening nails made from titanium alloy allowed limited weight-bearing. In contrast, the newer nails made of stainless steel allow increased weight-bearing. An objective comparison of the rate of healing of the regenerate bone based on the weight-bearing capabilities of these two types of lengthening nails has not been evaluated. The hypothesis for the study is that earlier commencement of full weight-bearing in patients treated with the stainless steel STRYDE nail will lead to faster healing of the regenerate bone during intramedullary limb lengthening compared with those treated with the titanium PRECICE nail.
Thirty patients, divided into two groups of 15 each, underwent antegrade intramedullary lengthening of the femur using a magnetic lengthening nail between May 2017 and November 2020. The pixel value ratio (PVR) obtained from serial digital radiographs was used to quantitatively determine the regenerate bone's mineralisation rate. We compared the rate of healing of the regenerate bone in both groups of patients using the PVR.
Patients treated with the STRYDE nail achieved unassisted full weight-bearing significantly earlier than patients treated with the PRECICE nail (12 weeks vs 17 weeks for STRYDE and PRECICE nail-lengthened patients, respectively, = 0.003). There was no difference in the PVR between both groups of patients at the time of full weight-bearing ( = 0.0857). However, patients treated with the STRYDE® nail attained a PVR of 1 significantly earlier than those treated with the PRECICE nail (0.0317).
The STRYDE nail provides an earlier return of function and full weight-bearing compared with the PRECICE lengthening nail. Earlier commencement of weight-bearing ambulation leads to more rapid mineralisation of the regenerate bone in patients undergoing intramedullary limb lengthening.
Bafor A, Duncan ME, Iobst CA, . Early Weight-bearing Accelerates Regenerate Bone Mineralisation: A Pilot Study Comparing Two Post-operative Weight-bearing Protocols Following Intramedullary Limb Lengthening Using the Pixel Value Ratio. Strategies Trauma Limb Reconstr 2022;17(3):148-152.
肢体延长越来越多地通过髓内延长钉来完成。以前由钛合金制成的磁性延长钉允许有限的负重。相比之下，较新的由不锈钢制成的钉子允许增加负重。基于这两种类型延长钉的负重能力，对再生骨愈合速度进行客观比较尚未得到评估。本研究的假设是，与使用钛制PRECICE钉治疗的患者相比，使用不锈钢STRYDE钉治疗的患者更早开始完全负重将导致在髓内肢体延长过程中再生骨愈合更快。
2017年5月至2020年11月期间，30例患者接受了使用磁性延长钉进行的股骨顺行髓内延长，分为两组，每组15例。从系列数字X线片获得的像素值比（PVR）用于定量确定再生骨的矿化率。我们使用PVR比较两组患者再生骨的愈合速度。
使用STRYDE钉治疗的患者比使用PRECICE钉治疗的患者显著更早实现无辅助完全负重（STRYDE钉和PRECICE钉延长的患者分别为12周和17周，P = 0.003）。两组患者在完全负重时的PVR没有差异（P = 0.0857）。然而，使用STRYDE®钉治疗的患者比使用PRECICE钉治疗的患者显著更早达到PVR为1（P = 0.0317）。
与PRECICE延长钉相比，STRYDE钉能更早恢复功能和实现完全负重。更早开始负重行走可使接受髓内肢体延长的患者再生骨矿化更快。
Bafor A, Duncan ME, Iobst CA, 。早期负重加速再生骨矿化：一项使用像素值比比较髓内肢体延长术后两种负重方案的初步研究。《创伤肢体重建策略》2022；17(3):148 - 152。
