摘要
目的比较Masquelet技术与Ilizarov技术治疗成人胫骨慢性骨髓炎清创后大段骨缺损的早期临床疗效。方法回顾性分析2011年1月至2015年5月我院收治的45例成人胫骨慢性骨髓炎病人资料,Masquelet技术治疗的27例纳入Masquelet组,男20例,女7例,骨缺损长度为(8.9±2.2)cm;Ilizarov技术治疗的18例纳入Ilizarov组,男12例,女6例,骨缺损长度为(8.3±2.1)cm。收集并比较两组病例的骨愈合时间、完全负重时间、术后并发症情况及末次随访时的Iowa膝关节评分、Iowa踝关节评分、SF-36量表得分。结果 45例病人的随访时间为12~38个月,平均(21.5±6.5)个月。Masquelet组与Ilizarov组的骨愈合时间分别为(20.85±4.31)周、(28.86±6.47)周,完全负重时间分别为(23.17±6.93)周、(32.87±6.79)周,两组间比较,差异均有统计学意义(t=4.944,P<0.0001;t=4.636,P<0.0001);两组末次随访时的Iowa膝、踝关节评分及SF-36量表总得分均较术前明显改善,但两组间比较,差异均无统计学意义(P均>0.05)。结论 Masquelet技术与Ilizarov技术均可有效地解决成人胫骨慢性骨髓炎清创后大段骨缺损问题,但Masquelet技术能显著缩短治疗周期,完全负重时间早,是一种简单有效的手术方法。
Objective To compare the clinical curative effects of Masquelet technique vs.Ilizarov technique in the treatment of large bone defects after debridement with chronic osteomyelitis of tibia in adult patients.Methods A retrospective analysis of45cases of adult chronic osteomyelitis of tibia in our hospital from January2011to May2015was performed.Twenty-seven cases treated by Masquelet technique were included in the Masquelet group including20males and7females,and the length of bone defect was(8.9±2.2)cm,while18cases treated by Ilizarov technique were included in the Ilizarov group including12males and6females,and the length of bone defect was(8.3±2.1)cm.The bone healing time,weight-bearing time,complications,Iowa knee score,Iowa ankle score and SF?36scale score were collected and compared between the two groups.Results Forty?five patients were followed up for12?38months,with an average of(21.5±6.5)months.The bone healing time in Masquelet group and Ilizarov group was(20.85±4.31)weeks and(28.86±6.47)weeks,and weight-bearing time was(23.17±6.93)weeks and(32.87±6.79)weeks respectively,with the differences between the two groups being statistically significant(t=4.944,P<0.0001;t=4.636,P<0.0001).The Iowa scores of knee and ankle joint,and SF-36score in the two groups at the last follow-up were significantly improved as compared with those preoperation,but there was no significant difference between the two groups(P>0.05for all).Conclusion Masquelet technique and Ilizarov technique could solve the problem of chronic osteomyelitis after debridement of adult tibial large bone defect,but Masquelet technique could significantly shorten the treatment period and weight-bearing time,and is a simple and effective surgical method.
作者
孙志波
郭骏
陈荣
郭潇
李相伟
肖亮
赵林
陈驰
禹志宏
SUN Zhibo;GUO Jun;CHEN Rong;GUO Xiao;LI Xiangwei;XIAO Liang;ZHAO Lin;CHEN Chi;YU Zhihong(Department of Traumatic Orthopaedics, Renmin Hospital, Hubei University of Medicine, Shiyan 442000, China)
出处
《骨科》
CAS
2017年第5期349-353,359,共6页
ORTHOPAEDICS
