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[1]徐云欽,李強,申屠剛,等.股骨外側(cè)髁環(huán)鋸取骨法與傳統(tǒng)髂骨翼外側(cè)板取骨法 在脛骨平臺骨折合并骨缺損治療中的對比研究[J].中醫(yī)正骨,2013,25(10):9-13.
　Xu Yunqin*,Li Qiang,Shen Tugang,et al.A retrospective trial of taking bone graft from lateral femoral condyle using trepan versus taking bone graft from lateral plate of iliac ala for tibial plateau fracture combined with bone defect[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(10):9-13.
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股骨外側(cè)髁環(huán)鋸取骨法與傳統(tǒng)髂骨翼外側(cè)板取骨法 在脛骨平臺骨折合并骨缺損治療中的對比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第25卷
期數(shù):
2013年10期
頁碼:
9-13
欄目:
臨床研究
出版日期:
2013-10-30

文章信息/Info

Title:
A retrospective trial of taking bone graft from lateral femoral condyle using trepan versus taking bone graft from lateral plate of iliac ala for tibial plateau fracture combined with bone defect
作者:
徐云欽; 李強; 申屠剛; 蘇佩華; 王剛; 姚有榕; 鄧盼; 羅正理; 魏強強; 湯勇
中國人民解放軍第九八醫(yī)院,浙江 湖州 313000
Author(s):
Xu Yunqin*; Li Qiang; Shen Tugang; Su Peihua; Wang Gang; Yao Yourong; Deng Pan; Luo Zhengli; Wei Qiangqiang; Tang Yong.*
The 98th hospital of PLA,Huzhou 313000,Zhejiang,China
關(guān)鍵詞:
脛骨骨折 脛骨平臺 骨缺損 環(huán)鋸取骨器 骨移植 治療; 臨床研究性
Keywords:
Tibial fractures;  Tibial plateau;  Bone defect;  Trepan osteotomes;  Bone transplantation;  Therapies; investigational
摘要:
目的:比較股骨外側(cè)髁環(huán)鋸取骨法與傳統(tǒng)髂骨翼外側(cè)板取骨法在治療脛骨平臺骨折合并骨缺損中的臨床療效與安全性。方法:回顧性分析55例脛骨平臺骨折合并骨缺損患者的病例資料,其中采用自制環(huán)鋸取骨器于股骨外側(cè)髁取骨25例(A組),采用骨刀于髂骨翼外側(cè)板取骨30例(B組); SchatzkerⅢ型10例,Ⅴ型26例,Ⅵ19例。記錄并比較2組患者的切口長度、術(shù)中出血量、手術(shù)時間、取骨量、骨折愈合時間及術(shù)后并發(fā)癥的發(fā)生情況。參照Merchant膝關(guān)節(jié)功能評分標準評定2組患者的臨床療效。結(jié)果:①一般指標。A組患者的切口長度、術(shù)中出血量、手術(shù)時間均小于B組[(2.86±0.42)cm,(3.98±0.65)cm,t=7.449,P=0.000;(295.50±68.55)mL,(389.20±97.55)mL,t=4.389,P=0.000;(1.53±0.26)min,(1.86±0.30)min,t=4.390,P=0.000]; 2組患者取骨量、骨折愈合時間比較,組間差異無統(tǒng)計學(xué)意義[(12.45±1.97)cm3,(12.15±1.78)cm3,t=0.229,P=0.820;(144.00±21.41)d,(140.30±16.66)d,t=0.998,P=0.323]。②臨床療效。A組優(yōu)13例、良9例、可2例、差1例,B組優(yōu)14例、良12例、可3例、差1例。2組患者臨床療效比較,差異無統(tǒng)計學(xué)意義(Z=-0.363,P=0.717)。③安全性。A組患者發(fā)生并發(fā)癥2例,B組患者發(fā)生并發(fā)癥9例。A組并發(fā)癥發(fā)生率低于B組(χ2=4.125,P=0.042)。結(jié)論:對于SchatzkerⅢ、Ⅴ、Ⅵ型脛骨平臺骨折患者而言,雖然股骨外側(cè)髁環(huán)鋸取骨法與傳統(tǒng)髂骨翼外側(cè)板取骨法在取骨量、骨折愈合時間及臨床療效方面無明顯差異,但股骨外側(cè)髁環(huán)鋸取骨法具有創(chuàng)傷小、操作簡單、手術(shù)時間短、并發(fā)癥少等優(yōu)點,是治療脛骨平臺骨折合并骨缺損的一種較理想的方法,值得臨床推廣應(yīng)用。
Abstract:
Objective:To compare the clinical curative effect and safety of taking bone graft from lateral femoral condyle using trepan versus taking bone graft from lateral plate of iliac ala for tibial plateau fracture combined with bone defect.Methods:The clinical records of 55 patients with tibial plateau fracture combined with bone defect were analyzed retrospectively.Twenty-five patients(group A)were taken bone graft from lateral femoral condyle using homemade trepan,while the others(group B)were taken bone graft from lateral plate of iliac ala using osteotomes.The fractures belonged to Schatzker typesⅢ(10),Ⅴ(26)andⅥ(19).The incision length,blood loss,operative time,volume of bone graft,fracture healing time and postoperative complications were recorded and compared between the 2 groups.The clinical curative effects were evaluated according to Merchant knee joint function scores.Results:The incision length,blood loss and operative time of group A were less than those of group B(2.86+/-0.42 vs 3.98+/-0.65 cm,t=7.449,P=0.000; 295.50+/-68.55 vs 389.20+/-97.55 mL,t=4.389,P=0.000; 1.53+/-0.26 vs 1.86+/-0.30 min,t=4.390,P=0.000).There was no statistical difference in volume of bone graft and fracture healing time between the 2 groups(12.45+/-1.97 vs 12.15+/-1.78 cm(3),t=0.229,P=0.820; 144.00+/-21.41 vs 140.30+/-16.66 days,t=0.998,P=0.323).Thirteen patients obtained excellent outcomes,9 good,2 fair and 1 poor in the group A,While 14 patients obtained excellent outcomes,12 good,3 fair and 1 poor in the group B.There was no statistical difference in the clinical curative effects between the 2 groups(Z=-0.363,P=0.717).Two patients developed complications in the group A,while 9 patients developed complications in the group B.The complication rate of the group A was lower than that of the group B(χ2=4.125,P=0.042).Conclusion:There is no significant difference in volume of bone graft,fracture healing time and clinical curative effects between the method of taking bones graft from lateral femoral condyle using trepan and the traditional method of taking bones graft from lateral plate of iliac ala for the patients with Schatzker typesⅢ,Ⅴ,Ⅵtibial plateau fracture combined with bone defect.However,taking bone graft from lateral femoral condyle using trepan is an ideal method for tibial plateau fracture combined with bone defect for less invasion,simple operation,short operative time and less complication,and it is worthy of popularizing in clinic.

參考文獻/References:

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備注/Memo

備注/Memo:
2012-12-10收稿 2013-05-05修回
基金項目:南京軍區(qū)醫(yī)學(xué)科技創(chuàng)新面上A類項目(11MA009),國家實用新型專利(ZL201220121958.2)
更新日期/Last Update: 2013-10-30