Ilizarov治療脛骨骨缺損后小腿功能評價及相關(guān)因素分析
發(fā)布時間：2018-12-19 15:53
【摘要】：目的隨著時代的不斷進(jìn)步,高能量創(chuàng)傷導(dǎo)致的脛骨大段骨缺損成為骨科臨床醫(yī)生面臨的難題。20世紀(jì)50年代,前蘇聯(lián)科學(xué)家Ilizarov發(fā)明環(huán)形骨外固定器,并通過大量的臨床實(shí)踐及科研研究形成了張力-應(yīng)力法則,再次于70年代獨(dú)創(chuàng)骨搬移技術(shù)。通過國內(nèi)外的臨床實(shí)踐研究,Ilizarov骨段滑移術(shù)可以有效地治愈脛骨大段骨缺損。而影響Ilizarov骨段滑移術(shù)治療脛骨大段骨缺損療效的相關(guān)因素報道較少。本課題對應(yīng)用Ilizarov技術(shù)骨段滑移治療脛骨大段骨缺損在6~10cm范圍內(nèi)的病例回顧性分析和歸納總結(jié)。探討脛骨大段骨缺損行Ilizarov技術(shù)骨段滑移術(shù)的治療效果及相關(guān)因素分析指導(dǎo)臨床工作。方法對2008年1月~2014年6月,收治63例脛骨大段骨缺損患者進(jìn)行回顧性分析:應(yīng)用Ilizarov技術(shù)骨段滑移治療脛骨上段骨缺損28例為A組,應(yīng)用Ilizarov技術(shù)骨段滑移治療下段骨缺損35例為B組。對A、B兩組病例相關(guān)變量分析,對年齡、性別、骨缺損幅度、截骨平面以及對A、B兩組去除外固定架后1個月、2個月、3個月、6個月進(jìn)行小腿功能即膝、踝關(guān)節(jié)功能進(jìn)行評定及統(tǒng)計(jì)學(xué)分析。結(jié)果63例患者術(shù)后平均隨訪15~24個月,脛骨骨缺損平均長度6cm~10cm,延長天數(shù)100天~150天,拆外固定架時間8個月~12個月,愈合指數(shù)35~41天/cm,所有骨缺損均愈合,愈合時間為7個月~23個月。所有患者骨缺損均達(dá)到愈合,患者去除環(huán)式外固定架后膝、踝關(guān)節(jié)功能明顯恢復(fù)。結(jié)論1 Ilizarov技術(shù)骨段滑移治療脛骨大段骨缺損術(shù)后效果顯著。2大段脛骨骨缺損的患者經(jīng)Ilizarov技術(shù)骨段滑移后撤除環(huán)式外固定架,通過功能鍛煉可以恢復(fù)到與患者健側(cè)小腿正常活動功能無明顯區(qū)別。3 Ilizarov技術(shù)骨段滑移治療脛骨大段骨缺損后,骨缺損幅度越大去除外固定架后膝、踝關(guān)節(jié)功能越差。4 Ilizarov技術(shù)骨段滑移治療脛骨大段骨缺損后,年齡越大去除外固定架后膝、踝關(guān)節(jié)功能越差。5 Ilizarov技術(shù)骨段滑移治療脛骨骨缺損截骨平面在脛骨下段比在脛骨上段術(shù)后膝、踝關(guān)節(jié)功能恢復(fù)差。
[Abstract]:Objective with the development of the times, the defect of large segment of tibia caused by high energy trauma has become a difficult problem for orthopedic clinicians. In the 1950s, Ilizarov, a former Soviet scientist, invented the ring bone external fixator. The tension-stress rule was formed through a lot of clinical practice and scientific research. According to the clinical research at home and abroad, Ilizarov segmental slippage can effectively cure the large tibial bone defect. However, the related factors affecting the treatment of large tibial bone defect with Ilizarov segmental slippage were less reported. In this study, we retrospectively analyzed and summarized the cases of large tibial bone defect treated by Ilizarov technique in the range of 6~10cm. Objective: to investigate the effect of Ilizarov technique in the treatment of large tibial bone defect and related factor analysis to guide clinical work. Methods from January 2008 to June 2014, 63 patients with large tibial bone defects were retrospectively analyzed. 28 patients with upper tibial bone defects were treated with Ilizarov technique. 35 cases of lower bone defect were treated with Ilizarov technique. The related variables were analyzed in two groups: age, sex, extent of bone defect, osteotomy level and knee function of calf after removal of external fixator for 1 month, 2 months, 3 months and 6 months after removal of external fixator in group A and B, respectively. Ankle function was evaluated and statistically analyzed. Results 63 patients were followed up for an average of 15 ~ 24 months, the average length of tibial bone defect was 6 cm / 10 cm, the lengthening time was 100 ~ 150 days, the time of removing external fixator was 8 months ~ 12 months, and the healing index was 3541 days / cm,. The healing time ranged from 7 months to 23 months. The bone defect of all the patients was healed, the knee was removed from the ring external fixator, and the ankle function was obviously restored. Conclusion (1) the effect of Ilizarov technique on the treatment of large tibial bone defect is remarkable. 2 the patients with large tibial bone defect were removed the ring external fixator after Ilizarov technique. There was no significant difference between the normal activity function of the leg and that of the normal leg by functional exercise. (3) after the large tibial bone defect was treated with Ilizarov technique, the greater the extent of bone defect was, the greater the removal of the external fixator and the knee. The worse the function of ankle joint was. 4 after the treatment of large tibial bone defect with Ilizarov technique, the older the knee was, the older the external fixator was removed. The lower the function of ankle joint, the worse the functional recovery of ankle joint was. 5. The level of osteotomy in the lower tibia was lower than that in the upper tibia.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3
本文編號：2387135
[Abstract]:Objective with the development of the times, the defect of large segment of tibia caused by high energy trauma has become a difficult problem for orthopedic clinicians. In the 1950s, Ilizarov, a former Soviet scientist, invented the ring bone external fixator. The tension-stress rule was formed through a lot of clinical practice and scientific research. According to the clinical research at home and abroad, Ilizarov segmental slippage can effectively cure the large tibial bone defect. However, the related factors affecting the treatment of large tibial bone defect with Ilizarov segmental slippage were less reported. In this study, we retrospectively analyzed and summarized the cases of large tibial bone defect treated by Ilizarov technique in the range of 6~10cm. Objective: to investigate the effect of Ilizarov technique in the treatment of large tibial bone defect and related factor analysis to guide clinical work. Methods from January 2008 to June 2014, 63 patients with large tibial bone defects were retrospectively analyzed. 28 patients with upper tibial bone defects were treated with Ilizarov technique. 35 cases of lower bone defect were treated with Ilizarov technique. The related variables were analyzed in two groups: age, sex, extent of bone defect, osteotomy level and knee function of calf after removal of external fixator for 1 month, 2 months, 3 months and 6 months after removal of external fixator in group A and B, respectively. Ankle function was evaluated and statistically analyzed. Results 63 patients were followed up for an average of 15 ~ 24 months, the average length of tibial bone defect was 6 cm / 10 cm, the lengthening time was 100 ~ 150 days, the time of removing external fixator was 8 months ~ 12 months, and the healing index was 3541 days / cm,. The healing time ranged from 7 months to 23 months. The bone defect of all the patients was healed, the knee was removed from the ring external fixator, and the ankle function was obviously restored. Conclusion (1) the effect of Ilizarov technique on the treatment of large tibial bone defect is remarkable. 2 the patients with large tibial bone defect were removed the ring external fixator after Ilizarov technique. There was no significant difference between the normal activity function of the leg and that of the normal leg by functional exercise. (3) after the large tibial bone defect was treated with Ilizarov technique, the greater the extent of bone defect was, the greater the removal of the external fixator and the knee. The worse the function of ankle joint was. 4 after the treatment of large tibial bone defect with Ilizarov technique, the older the knee was, the older the external fixator was removed. The lower the function of ankle joint, the worse the functional recovery of ankle joint was. 5. The level of osteotomy in the lower tibia was lower than that in the upper tibia.
【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R687.3
【參考文獻(xiàn)】
相關(guān)期刊論文 前3條
1 佟冰渡;李楊;;外固定和骨牽引病人住院期間針道感染發(fā)生狀況的比較與分析[J];護(hù)理研究;2013年33期
2 左健;康建敏;潘樂;;同種異體骨移植用于骨缺損修復(fù)的應(yīng)用現(xiàn)狀[J];中國組織工程研究;2012年18期
3 高輝;肖樹軍;陳雷;李傳福;吳學(xué)東;韓丹;;改良Illizarov技術(shù)治療下肢感染性骨缺損[J];中國骨傷;2006年11期
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