Andersen L R, Johannsen H G, Ernst C, Weeth E R
Ortopaedkirurgisk afdeling, Odense Universitetshospital.
Ugeskr Laeger. 1996 Apr 15;158(16):2237-40.
In the period from the 1.1.1991 to the 31.5.1993 17 patients with a tibial pseudoarthrosis were treated by the Ilizarov method. The mean age was 35 years (13-88 years). Mean time from fracture to operation for pseudoarthrosis was 14.6 months (3-39 months). There were two hypertrophic, 14 atrophic and one defect pseudoarthrosis. Six of the pseudoarthroses were infected. After stable external fixation the treatment was compression over the pseudoarthrosis in four cases and alternating distraction and compression in eight cases. In five cases the treatment was supplemented by bone transport for the defects between 15 and 50 mm. Mean time of treatment with the external fixator was 5.2 months (2-11.5 months). The overall treatment time was 9.8 months (3-19 months). At the follow-up 14 pseudoarthroses were fully consolidated, one patient was still using an orthosis, and three patients were in need of reoperation with bone transplantation. During the period of fixation thirteen patients were hospitalized for short periods, and some of them several times. The treatments were for correction of the distraction, replacement of fixation of pintrack infection or treatment of pain. The Ilizarov method of treatment of pseudoarthrosis show a good stimulation of healing, but experience with the fixator system and aggressive treatment of various minor complications are essential for a successful outcome.
在1991年1月1日至1993年5月31日期间,采用伊里扎洛夫方法治疗了17例胫骨假关节患者。平均年龄为35岁(13 - 88岁)。假关节从骨折到手术的平均时间为14.6个月(3 - 39个月)。其中有2例肥大性、14例萎缩性和1例缺损性假关节。6例假关节存在感染。在稳定的外固定后,4例患者对假关节进行加压治疗,8例患者采用交替牵引和加压治疗。5例患者因15至50毫米的缺损采用骨搬运进行补充治疗。外固定器的平均治疗时间为5.2个月(2 - 11.5个月)。总体治疗时间为9.8个月(3 - 19个月)。随访时,14例假关节完全愈合,1例患者仍在使用矫形器,3例患者需要再次手术进行骨移植。在固定期间,13例患者短期住院,其中一些患者住院了几次。治疗目的是纠正牵引、更换针道感染的固定或治疗疼痛。伊里扎洛夫方法治疗假关节显示出对愈合有良好的刺激作用,但对于成功的治疗结果,熟悉固定器系统并积极处理各种轻微并发症至关重要。