摘要
背景:大段跖骨缺损由足部创伤、感染等原因导致,其发生率日益增加,且处理较为棘手,其治疗亟待解决。目的:探讨应用单边外固定支架骨搬运治疗大段跖骨缺损的临床疗效。方法:回顾性分析2015年1月至2018年10月收治的8例大段跖骨缺损患者。均采用单边外固定支架进行跖骨骨搬运治疗,根据骨痂直径率(CDR值)及时调整牵拉速度。记录骨折愈合时间、带架时间及并发症等,记录美国足踝骨科学会评分(AOFAS)以评价跖趾关节(MTP)功能。结果:所有患者均获得随访,随访时间12~31个月,平均随访时间(18.0±2.4)个月。在骨搬运过程中,钉道感染1例。因搬运速度相对于矿化速度慢,出现搬运段半钉弯曲1例,需重新更换半钉及截骨搬运。骨愈合时间3~12个月,平均(6.9±1.2)个月。外固定支架携带时间3.6~13.5个月,平均(6.8±1.4)个月。术后12个月AOFAS评分高于术前[(77.1±2.4)分vs(50.3±1.9)分],且差异有统计学意义(P<0.05)。术后12个月MTP功能为优5例,良2例,可1例,优良率87.5%(7/8)。结论:应用单边外固定架进行骨搬运治疗大段跖骨缺损有效。
Background:Extensive metatarsal bone defects are mainly caused by foot trauma and infection.Its incidence is increasing,and the treatment is troublesome.Objective:To investigate the clinical effect of unilateral external fixator in the treatment of extensive metatarsal bone defects.Methods:Eight patients with extensive metatarsal bone defects treated with unilateral external fixation for bone transport from January 2015 to October 2018 were retrospectively analyzed.The traction speed was adjusted according to callus diameter rate(CDR).The time of fracture healing,the time of external fixation and complications were recorded.The function of the metatarsophalangeal(MTP)joint was evaluated by the American Orthopaedic Foot and Ankle Society(AOFAS)scoring.Results:The patients were followed up for 12-31 months,with an average of(18.0±2.4)months.Nail track infection occurred in one patient.Half-pin bending occurred in one patient because the transport speed was slower than the mineralization speed.The mean bone healing time was(6.9±1.2)months(range,3-12 months).The mean time of external fixation was(6.8±1.4)months(range,3.6-13.5 months).AOFAS score at 12 months after treatment was significantly higher than that before treatment(77.1±2.4 vs 50.3±1.9,P<0.05).Th MTP function was excellent in 5 cases,good in 2 cases,and fair in 1 case.The excellent and good rate was 87.5%(7/8).Conclusions:Unilateral external fixation is an effective treatment for extensive metatarsal bone defects.
作者
肖庭辉
林依淼
贾兆锋
任晋可
李广恒
张晓明
XIAO Tinghui;LIN Yimiao;JIA Zhaofeng;REN Jinke;LI Guangheng;ZHANG Xiaoming(Department of Osteoarthropathy,Shenzhen People's Hospital,Shenzhen 518020,Guangdong,China)
出处
《中华骨与关节外科杂志》
2021年第3期210-214,共5页
Chinese Journal of Bone and Joint Surgery
基金
深圳市科技计划项目(JCYJ20190806160014794)
关键词
大段跖骨缺损
骨搬运
骨延长术
ILIZAROV技术
Extensive Metatarsal Bone Defects
Bone Transport
Bone Lengthening
Ilizarov Technique
