本文選題：軸向應(yīng)力刺激 + 脛腓骨開放骨折　； 參考：《中國修復(fù)重建外科雜志》2017年08期

【摘要】：目的探討脛腓骨開放骨折行Taylor空間支架外固定術(shù)后,軸向應(yīng)力刺激對(duì)促進(jìn)骨折愈合的臨床療效。方法回顧分析2015年1月—2016年6月收治的符合選擇標(biāo)準(zhǔn)的45例脛腓骨開放骨折患者臨床資料,均行Taylor空間支架閉合復(fù)位外固定術(shù),根據(jù)術(shù)后是否進(jìn)行軸向應(yīng)力刺激分為試驗(yàn)組(23例)和對(duì)照組(22例)。兩組患者性別、年齡、側(cè)別、致傷原因、骨折分型及受傷至手術(shù)時(shí)間等一般資料比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05),具有可比性。術(shù)后對(duì)試驗(yàn)組進(jìn)行軸向應(yīng)力刺激;兩組均行軸向載荷分擔(dān)比值測(cè)試,該值10%時(shí)拆除外固定。記錄并比較兩組患者骨折愈合時(shí)間、完全負(fù)重時(shí)間及拆除外固定支架時(shí)間;拆除外固定支架6個(gè)月后,參照J(rèn)ohner-Wruhs脛骨干骨折治療最終效果評(píng)價(jià)標(biāo)準(zhǔn)評(píng)定患肢功能。結(jié)果試驗(yàn)組和對(duì)照組各有2例和3例發(fā)生針道異物反應(yīng),予以對(duì)癥抗過敏治療后好轉(zhuǎn)。45例患者均獲隨訪,隨訪時(shí)間8~12個(gè)月,平均10個(gè)月�；颊吖钦劬_(dá)臨床愈合,無延遲愈合、不愈合及骨髓炎等并發(fā)癥發(fā)生。試驗(yàn)組骨折愈合時(shí)間、完全負(fù)重時(shí)間和拆除外固定支架時(shí)間均顯著短于對(duì)照組(P0.05)。拆除外固定支架6個(gè)月后,參照J(rèn)ohner-Wruhs脛骨干骨折治療最終效果評(píng)價(jià)標(biāo)準(zhǔn)評(píng)定患肢功能,試驗(yàn)組優(yōu)13例、良6例、中3例、差1例,優(yōu)良率82.6%;對(duì)照組優(yōu)5例、良10例、中4例、差3例,優(yōu)良率為68.2%;兩組比較差異有統(tǒng)計(jì)學(xué)意義(Z= 2.146,P=0.032)。結(jié)論 Taylor空間支架外固定術(shù)后行軸向應(yīng)力刺激能促進(jìn)脛腓骨開放骨折的愈合,促進(jìn)骨折處局部骨形成。
[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.
【作者單位】： 天津中醫(yī)藥大學(xué)研究生院;天津醫(yī)院創(chuàng)傷骨科;天津醫(yī)科大學(xué)研究生院;
【分類號(hào)】：R687.3

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