摘要
目的探讨微创截骨Ilizarov技术结合髓内钉进行股骨延长治疗股骨短缩畸形的效果。方法将2013年1月—2016年6月收治并符合选择标准的71例股骨短缩畸形患者,随机分为试验组(36例,采用微创截骨Ilizarov技术结合带锁髓内钉进行股骨延长)和对照组(35例,采用单纯Ilizarov技术进行股骨延长)。两组患者年龄、性别、股骨短缩原因、股骨短缩长度、股骨合并畸形比例等一般资料比较差异均无统计学意义(P>0.05),具有可比性。记录并比较两组患者手术时间、术中出血量、延长速度、外固定器佩戴时间、针道感染例数、截骨愈合时间、术后1年膝关节活动度。结果两组患者均获随访,随访时间12～60个月,平均31个月。试验组1例1针、对照组7例9针发生针道感染,均经更换固定针、积极换药、使用抗生素及加强护理后治愈;两组针道感染发生率比较差异有统计学意义(χ~2=5.265,P=0.022)。试验组手术时间长于对照组,术中出血量大于对照组,外固定器佩戴时间、截骨愈合时间及术后1年膝关节活动度均优于对照组,差异有统计学意义(P<0.05);两组延长速度比较差异无统计学意义(t=-1.581,P=0.153)。结论微创截骨Ilizarov技术结合髓内钉进行股骨延长虽然增加了手术时间及术中出血量,但显著缩短了患者佩戴外固定器的时间,减少了针道感染概率,改善了术后关节功能。
Objective To explore the effectiveness of minimally invasive osteotomy Ilizarov technique combinedwith intramedullary nail for femoral lengthening. Methods Seventy-one patients with femoral shortening deformity whomet the selection criteria between January 2013 and June 2016 were randomly divided into trial group (36 cases weretreated with minimally invasive osteotomy Ilizarov technique combined with intramedullary nail for femoral lengthening)and control group (35 cases were treated with simple Ilizarov technique for femoral lengthening). There was no significantdifference in age, gender, causes of femoral shortening, length of femoral shortening, rate of femoral deformity betweenthe two groups (P>0.05). The operation duration, intraoperative blood loss, lengthening rate, external fixation duration,frequency of pin tract infection, osteotomy healing time, and range of motion (ROM) of knee at 1 year after operationwere recorded and compared between the two groups. Results The patients of two groups were followed up 12-60months (mean, 31 months). Pin tract infection occured in 8 cases (10 pins), including 1 case (1 pin) in the trial group and7 cases (9 pins) in the control group. There was significant difference in the incidence of pin tract infection between thetwo groups (χ2=5.265, P=0.022). All patients were cured by replacing the fixation pins, changing dressing actively,application of antibiotics, and adequate postoperative care. The operation duration, intraoperative blood loss, externalfixation duration, osteotomy healing time, and ROM of knee at 1 year after operation of the trial group were superior tothose of the control group, showing significant differences (P<0.05). There was no significant difference in the lengtheningrate between the two groups (t=-1.581, P=0.153). Conclusion The minimally invasive osteotomy Ilizarov techniquecombined with intramedullary nail in femoral lengthening increases the operation time, but the external fixation durationand incidence of pin tract infection are significantly reduced and the function of knee is significantly improved.
作者
杨华清
章耀华
韩庆海
彭爱民
郑学建
秦泗河
夏和桃
YANG Huaqing;ZHANG Yaohua;HAN Qinghai;PENG Aimin;ZHENG Xuejian;QIN Sihe;XlA Hetao(Department of Orthopaedics,Beijing Rehabilitation Hospital of CapitaI Medical University,Beijing,100144,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2018年第12期1524-1529,共6页
Chinese Journal of Reparative and Reconstructive Surgery
基金
北京市科委首都临床特色应用研究(Z16110700050000)~~
关键词
股骨延长
微创截骨
ILIZAROV技术
髓内钉
外固定
Femoral lengthening
minimally invasive osteotomy
Ilizarov technique
intramedullary nail
externalfixation
