胫腓骨开放骨折Taylor空间支架外固定术后轴向应力刺激对骨折愈合的影响研究

发布时间：2018-07-03 06:44

本文选题：轴向应力刺激 + 胫腓骨开放骨折　；参考：《中国修复重建外科杂志》2017年08期

【摘要】：目的探讨胫腓骨开放骨折行Taylor空间支架外固定术后,轴向应力刺激对促进骨折愈合的临床疗效。方法回顾分析2015年1月—2016年6月收治的符合选择标准的45例胫腓骨开放骨折患者临床资料,均行Taylor空间支架闭合复位外固定术,根据术后是否进行轴向应力刺激分为试验组(23例)和对照组(22例)。两组患者性别、年龄、侧别、致伤原因、骨折分型及受伤至手术时间等一般资料比较,差异均无统计学意义(P0.05),具有可比性。术后对试验组进行轴向应力刺激;两组均行轴向载荷分担比值测试,该值10%时拆除外固定。记录并比较两组患者骨折愈合时间、完全负重时间及拆除外固定支架时间;拆除外固定支架6个月后,参照Johner-Wruhs胫骨干骨折治疗最终效果评价标准评定患肢功能。结果试验组和对照组各有2例和3例发生针道异物反应,予以对症抗过敏治疗后好转。45例患者均获随访,随访时间8~12个月,平均10个月。患者骨折均达临床愈合,无延迟愈合、不愈合及骨髓炎等并发症发生。试验组骨折愈合时间、完全负重时间和拆除外固定支架时间均显著短于对照组(P0.05)。拆除外固定支架6个月后,参照Johner-Wruhs胫骨干骨折治疗最终效果评价标准评定患肢功能,试验组优13例、良6例、中3例、差1例,优良率82.6%;对照组优5例、良10例、中4例、差3例,优良率为68.2%;两组比较差异有统计学意义(Z= 2.146,P=0.032)。结论 Taylor空间支架外固定术后行轴向应力刺激能促进胫腓骨开放骨折的愈合,促进骨折处局部骨形成。
[Abstract]:Objective to investigate the effect of axial stress stimulation on the healing of open tibia and fibula fracture. Methods the clinical data of 45 patients with open tibia and fibula fractures admitted from January 2015 to June 2016 were retrospectively analyzed. All patients were treated with Taylor space stent closed reduction and external fixation. According to whether the axial stress stimulation was performed after operation, the patients were divided into two groups: the experimental group (23 cases) and the control group (22 cases). There was no significant difference between the two groups in sex, age, side, cause of injury, fracture classification and time from injury to operation (P0.05). After operation, the axial stress stimulation was performed in the experimental group, and the axial load-sharing ratio was measured in both groups, and the external fixation was removed when the value was 10. The fracture healing time, total weight loading time and removal time of external fixator were recorded and compared between the two groups, and the function of affected limbs was evaluated according to the Johner-Wruhs tibial shaft fracture treatment final effect evaluation standard after 6 months of removal of external fixator. Results there were 2 cases in the test group and 3 cases in the control group respectively. The patients were followed up for 8 ~ 12 months (mean 10 months). No delayed healing, non-union, osteomyelitis and other complications occurred. The time of fracture healing, complete loading and removal of external fixation in the experimental group were significantly shorter than those in the control group (P0.05). After removal of external fixator for 6 months, the function of affected limb was evaluated according to Johner-Wruhs tibial shaft fracture final effect evaluation standard. The experimental group was excellent in 13 cases, good in 6 cases, fair in 3 cases, poor in 1 case, excellent and good in 82.6 cases, excellent in 5 cases, good in 10 cases, fair in 4 cases in the control group. The excellent and good rate was 68.2% in 3 cases, and the difference between the two groups was statistically significant (Z = 2.146P 0.032). Conclusion Axial stress stimulation can promote the healing of open tibia and fibula fracture and promote local bone formation after Taylor space stent fixation.
【作者单位】：天津中医药大学研究生院;天津医院创伤骨科;天津医科大学研究生院;
【分类号】：R687.3

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