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J Orthop Trauma:哪种牵张成骨方式的效果更佳?

2019-09-03 sunshine 译 MedSci原创

本研究旨在比较创伤后胫骨骨不连患者复合骨和软组织缺损的两种牵张成骨技术。采用非随机前瞻性,病例系列,单中心研究设计,在埃及开罗El-Helal医院肢体重建科骨科和创伤科,纳入 50例创伤后胫骨骨不连患者复合骨和软组织缺损的患者。25例患者采用骨转运(BT)技术治疗,25例患者采用急性缩短(AS)和牵引技术治疗。评估外固定指数(EFI),功能和骨骼结果,以及并发症发生率。结果显示,移除Ilizaro

本研究旨在比较创伤后胫骨骨不连患者复合骨和软组织缺损的两种牵张成骨技术。

采用非随机前瞻性,病例系列,单中心研究设计,在埃及开罗El-Helal医院肢体重建科骨科和创伤科,纳入 50例创伤后胫骨骨不连患者复合骨和软组织缺损的患者。

25例患者采用骨转运(BT)技术治疗,25例患者采用急性缩短(AS)和牵引技术治疗。评估外固定指数(EFI),功能和骨骼结果,以及并发症发生率。

结果显示,移除Ilizarov框架后,所有患者均被随访至少18个月。AS和BT组分别随访平均19.7和20.3个月。切除和清创后的平均骨间隙在AS组为4 cm,在BT组为5.9 cm(p = 0.06)。与BT组相比,AS组的平均EFI具有统计学意义且更低(p = 0.03)。两个干预组之间没有其他统计学上的显著差异。

总之,该研究结果表明,两种技术均获得了相当的优异结果,并且骨和功能的并发症数量和ASAMI评分的差异无统计学意义。然而,似乎AS技术可能更优越,因为它具有显着更低的EFI。然而,这在所有情况下都是不可行的,因为急性缩短技术受到缺陷尺寸和周围软组织状况的限制。

原始出处:

Thakeb MF, Fayyad TA, et al., Bifocal Compression-Distraction for combined Bone and Soft Tissue Defects in Post-traumatic Tibial Nonunion. J Orthop Trauma. 2019 Aug 29. doi: 10.1097/BOT.0000000000001514. 

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    2020-03-18 siiner
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    2020-05-15 bsmagic9140
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    2019-09-05 zhaojie88
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    2019-09-03 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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