Yang Xin, Hamiti Yimurang, Liu Kai, Wang Sulong, Kadier Xiriaili, Xiong Debin, Yusufu Aihemaitijiang
Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
Xinjiang Key Laboratory of Trauma Repair and Reconstruction, Urumqi, Xinjiang, China.
Front Surg. 2024 Dec 10;11:1494658. doi: 10.3389/fsurg.2024.1494658. eCollection 2024.
Bone transport techniques are crucial for managing large bone defects, but the optimal approach for different defect lengths remains unclear. This study aimed to compare bone regeneration rates between short bifocal bone transport (SBBT), long bifocal bone transport (LBBT), and trifocal bone transport (TBT) using pixel value ratio (PVR) as an objective quantitative measure.
This retrospective study included 60 patients undergoing lower limb bone transport, divided into SBBT ( = 22, defects <6 cm), LBBT ( = 20, defects ≥6 cm), and TBT ( = 18, defects ≥6 cm) groups. PVR was measured at 4, 8, and 12 weeks postoperatively using standardized digital radiographs. Healing index (HI) and external fixation index (EFI) were calculated to assess treatment efficiency. Demographic data, surgical characteristics, and complications were also analyzed.
TBT showed significantly higher PVR values compared to LBBT at all time points (4 weeks: 0.779 ± 0.036 vs. 0.719 ± 0.027, < 0.001; 8 weeks: 0.822 ± 0.027 vs. 0.787 ± 0.025, = 0.008; 12 weeks: 0.866 ± 0.024 vs. 0.835 ± 0.016, = 0.023) and to SBBT at 4 and 8 weeks ( < 0.001 and = 0.016, respectively). The TBT group demonstrated significantly lower HI and EFI compared to both SBBT and LBBT groups ( < 0.05), indicating faster healing and shorter treatment times. Although SBBT showed slightly higher PVR values than LBBT, the differences were not statistically significant.
Trifocal bone transport leads to faster bone regeneration and shorter treatment times compared to bifocal techniques, particularly for longer bone defects. The study demonstrates that defect length alone may not be the primary factor influencing regeneration rates in bifocal transport. PVR proves to be a reliable and cost-effective tool for assessing bone regeneration in different bone transport techniques, offering potential for guiding clinical decision-making. These findings suggest that trifocal transport should be considered as a preferred method for treating larger bone defects, especially when minimizing treatment time is crucial.
骨搬运技术对于处理大的骨缺损至关重要，但不同缺损长度的最佳方法仍不明确。本研究旨在使用像素值比（PVR）作为客观定量指标，比较短双焦点骨搬运（SBBT）、长双焦点骨搬运（LBBT）和三焦点骨搬运（TBT）之间的骨再生率。
这项回顾性研究纳入了60例行下肢骨搬运的患者，分为SBBT组（n = 22，缺损<6 cm）、LBBT组（n = 20，缺损≥6 cm）和TBT组（n = 18，缺损≥6 cm）。术后4周、8周和12周使用标准化数字X线片测量PVR。计算愈合指数（HI）和外固定指数（EFI）以评估治疗效率。还分析了人口统计学数据、手术特征和并发症。
在所有时间点，TBT的PVR值均显著高于LBBT（4周：0.779±0.036对0.719±0.027，P < 0.001；8周：0.822±0.027对0.787±0.025，P = 0.008；12周：0.866±0.024对0.835±0.016，P = 0.023），且在4周和8周时显著高于SBBT（分别为P < 0.001和P = 0.016）。与SBBT组和LBBT组相比，TBT组的HI和EFI显著更低（P < 0.05），表明愈合更快且治疗时间更短。尽管SBBT的PVR值略高于LBBT，但差异无统计学意义。
与双焦点技术相比，三焦点骨搬运可实现更快的骨再生和更短的治疗时间，尤其是对于较长的骨缺损。该研究表明，在双焦点骨搬运中，仅缺损长度可能不是影响再生率的主要因素。PVR被证明是评估不同骨搬运技术中骨再生可靠且经济有效的工具，为指导临床决策提供了可能。这些发现表明，三焦点骨搬运应被视为治疗较大骨缺损的首选方法，尤其是在将治疗时间降至最低至关重要时。
