摘要
要目的:探讨应用单节段与双节段骨搬运治疗胫骨骨感染伴软组织缺损的临床疗效。方法:回顾性队列对照研究,从我院2017年1月—2020年1月收治并获得完整随访的39例胫骨骨感染伴软组织缺损患者的临床资料。根据骨搬运节段数,分成单节段骨搬运(单节段组)20例,双节段骨搬运(双节段组)19例,常规行病灶清除,骨搬运技术治疗。对2组病例在骨愈合时间、创面愈合时间、外固定指数、外固定时间、并发症发生情况进行比较。应用Ilizarov技术研究与应用学会(ASAMI)评分标准进行骨愈合及功能评价。结果:39例患者均得到随访,随访时间21—46个月,平均24个月。创面均封闭,截骨处均获得骨性愈合。单节段组会师端愈合时间为(4.5±0.97)个月,双节段组会师端愈合时间为(4.56±1.01)个月(P>0.05);单节段组外固定带架时间为(21.5±2.84)个月,双节段组外固定带架时间为(13.33±1.73)个月(P<0.05);单节段组创面愈合时间3.25个月,双节段创面愈合时间1.5个月(P<0.05);单节段组外固定指数为(2.05±0.13)m/cm,双节段组外固定指数为(1.25±0.13)m/cm(P<0.05);单节段组并发症11例,双节段组并发症12例(P>0.05);按ASAMI评分标准,单节段组与双节段组骨愈合:优分别是19例与18例,良各1例;单节段组与双节段组功能评估为优者均为18例,良分别为2例及1例。结论:双节段骨搬运与单节段骨搬运治疗胫骨骨感染伴软组织缺损相比,能够降低外固定指数,创面愈合时间、缩短外固定佩戴时间;但对于骨愈合时间和并发症等方面无显著差异。
Objective:To investigate the clinical effect of single-segment and double-segment bone transport in treating tibial bone infection with soft tissue defect.Method:Retrospective cohort controlled study.The clinical data of 39 patients with tibial bone infection and softssue defects admited to Xuzhou Renci Hospital from January 2017 to January 2020 were obtained with complete fllow-up.According to the number of bone transport segments,20 patients were divided into single-segment bone transport group(single-segment group),including 13 males and 7 females.11l cases were right,9 cases were left;The age was(35.7±12.8)years;There were 19 cases of double-level bone transport(double-level group),including 12 males and 7 females.10 cases were right,9 cases were left;The age was(35.5±14.7)years.Routine debridement and bone transport were performed.The bone healing time,wound healing time,external fixation index,extermal fixation time and complications were compared between the two groups.Ilizarov Institute for Research and Application of Technology(ASAMI)score was used to evaluate bone healing and function.Result:All the 39 patients were followed up for 21 to 46 months(mean,24 months).All the wounds were closed,and bone healing was achieved at the osteotomy site.The healing time of the single segment group was(4.5±0.97)months,and that of the double segment group was(4.56±1.01)months(P>0.05).The time of external fixation belt was(21.5±2.84)months in the single-level group and(13.33±1.73)months in the double-level group(P<0.05).The healing time of single-level wound was 3.25(3,4,125)months,and that of double-level wound was 1.5(1.5,3)months(P<0.05).The external fixation index was(2.05±0.13)months/cm in the single-level group and(1.25±0.13)months/cm in the double-level group(P<0.05).There were 11 complications in single-segment group and 12 complications in double-segment group(P>0.05).According to the ASAMI score standard,the bone healing of single-segment group and double-segment group were excellent in 19 cases and 1
作者
徐明亮
伊力扎提·伊力哈木
陈国梁
董长红
彭爱民
石荣剑
XU Mingliang;Yilizati Yilihamu;CHEN Guoliang;PENG Aimin(Xuzhou mercy hospital,Xuzhou,Jiangsu 221004;Department of orthopaedics,Beijing rehabilitation hospital affiliated to capital medical university,Beijing 100041)
出处
《中国伤残医学》
2023年第23期5-10,共6页
Chinese Journal of Trauma and Disability Medicine
基金
2020年徐州市卫生健康委青年医学科技创新项目:XWKYHT20200022。
