[1]谭新欢 王凯君 孙晋客 张峻玮 杨庆民 聂伟志 毕宏政△.一期短缩再延长技术结合接骨药丸治疗开放性胫骨骨缺损的疗效观察[J].中国中医骨伤科杂志,2022,30(08):21-26+31.
　TAN Xinhuan WANG Kaijun SUN Jinke ZHANG Junwei YANG Qingmin NIE Weizhi BI Hongzheng.Observation on the Curative Efficacy of One Stage Shortening and Extension Technique Combined with Bone-Setting Pill in Treating Open Tibial Bone Defect[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2022,30(08):21-26+31.
点击复制

一期短缩再延长技术结合接骨药丸治疗开放性胫骨骨缺损的疗效观察()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第30卷
期数:
2022年08期
页码:
21-26+31
栏目:
临床研究
出版日期:
2022-08-15

文章信息/Info

Title:
Observation on the Curative Efficacy of One Stage Shortening and Extension Technique Combined with Bone-Setting Pill in Treating Open Tibial Bone Defect
文章编号:
1005-0205(2022)08-0021-06
作者:
谭新欢1 王凯君1 孙晋客1 张峻玮1 杨庆民1 聂伟志1 毕宏政1△
1山东省文登整骨医院(山东 文登,264400)
Author(s):
TAN Xinhuan1 WANG Kaijun1 SUN Jinke1 ZHANG Junwei1 YANG Qingmin1 NIE Weizhi1 BI Hongzheng1△
1WendengHospitial of Traditional Chinese Orthopedics and Traumatology of Shandong Province,Wendeng 264400,Shandong China.
关键词:
开放性骨折;  胫骨;  骨缺损;  骨搬运;  回顾性研究
Keywords:
open fracture;  tibia;  bone defect;  bone transport;  retrospective study
分类号:
R681.8
文献标志码:
A
摘要:
目的:探讨一期短缩再延长技术结合接骨药丸治疗开放性胫骨骨缺损的疗效。方法:回顾性分析2010年1月至2020年12月收治的67例开放性胫骨骨缺损患者的病例资料,所有患者均采用一期短缩再延长技术治疗,其中33例术后常规对症治疗,为对照组; 其余34例术后加服中药制剂接骨药丸治疗,为治疗组。比较两组患者在延长骨段骨密度、愈合指数及Paley骨搬运治疗骨缺损疗效评价方面的差异。结果:67例患者均获随访,随访时间12～18个月,中位数15个月,所有骨折均获愈合。两组患者术后延长骨段骨密度比较:术后4周差异无统计学意义(P>0.05); 术后8周、12周及16周,差异有统计学意义(P<0.05),治疗组优于对照组。术后愈合指数比较,差异有统计学意义(P<0.05),治疗组优于对照组。术后1年按Paley骨搬运治疗骨缺损疗效评价比较,差异有统计学意义(P<0.05),治疗组优于对照组。结论:一期短缩再延长技术治疗开放性胫骨骨缺损安全有效,结合接骨药丸治疗能明显提高牵拉区的成骨质量,促进骨折端的及早愈合,缩短了治疗周期,有利于肢体功能的恢复。
Abstract:
Objective:To investigate the efficacy of one stage shortening and extension technique combined with bone-setting pill in treating open tibial bone defect.Methods:67 patients with open tibial bone defect admitted from January 2010 to December 2020 were retrospectively analyzed.All patients were on the treatment of one-stage shortening and then extension technique,and 33 patients were on the treatment of conventional symptomatic treatment after having surgery,which was the control group.The other 34 cases were on the treatment of bone-fixing pills of Chinese medicine after having surgery,which were in the treatment group.The differences of bone mineral density(BMD),healing index(CI)and Paley bone transfer on the treatment of bone defects were compared between the two groups.Results:67 patients were followed up for 12 to 18 months,with a median of 15 months,and all fractures had healed.Comparison of postoperative extended bone segment BMD between the two groups:there was no statistically significant difference at 4 weeks after surgery,but there were statistically significant differences at 8,12 and 16 weeks after surgery(P<0.05),and the treatment group was superior to the control group.The postoperative healing index was statistically significant(P<0.05),and the treatment group was better than the control group.One year after surgery,Paley bone transport was used to treat bone defects,and the difference was statistically significant(P<0.05).The treatment group was superior to the control group.Conclusion:It is safe and effective to treat open tibial bone defect with one stage shortening and then lengthening technique.Combined with bone-setting pill,it can obviously improve the quality of bone formation in the traction area,promote the early healing of fracture end,shorten the treatment period,and benefit the recovery of limb function.

参考文献/References:

[1] 张树立,张勇,王景彦,等.应用Ilizarov双段骨搬运技术治疗大段胫骨骨缺损[J].中国中医骨伤科杂志,2018,26(10):60.
[2] O'TOOLE R V,JOSHI M,CARLINI A R,et al.Effect of intrawound vancomycin powder in operatively treated high-risk tibia fractures:a randomized clinical trial[J].JAMA Surg,2021,156(5):e207259.
[3] 秦泗河,臧建成,DROR PALEY.肢体延长的起源、理论突破与技术进展[J].中华骨科杂志,2020,40(11):749-753.
[4] 康庆林,孔令驰,李刚.Ilizarov技术基础研究进展[J].中华骨科杂志,2021,41(11):714-718.
[5] GUSTILO R B,ANDERSON J T.Prevention of infection in the treatment of one thousand and twenty five open fractures of long bones:retrospective and prospective analyses[J].J Bone Joint Surg Am,1976,58(4):453-458.
[6] 石博文,张克刚,陈旭,等.Ilizarov支架和单边支架治疗胫骨节段性骨缺损伴软组织缺损的疗效比较[J].中华创伤杂志,2020,36(2):163-170.
[7] 涂振兴,王斌,卢爱东,等.单平面截骨骨搬移联合髓内钉治疗胫骨骨缺损[J].中国组织工程研究,2022,26(12):1849-1853.
[8] 汪杰,梅先国,张周渝,等.抗生素骨水泥在开放性骨缺损早期治疗中的应用疗效观察[J].中国医药指南,2021,19(15):75-76.
[9] Al-UZRI M,THAHIR A,ABDULKARIM A,et al.Improving radio-graphic imaging for circular frames:the Cambridge experience[J].Arch Orthop Trauma Surg,2020,140(12):141-143.
[10] 殷海阳,张永红.骨搬移后对合端延迟愈合、不愈合的机制研究与规范化临床应用技术[J].中国组织工程研究,2020,24(36):5858-5863.
[11] 任义军,胡锐,严立,等.组织移植结合Ilizarov骨牵张技术重建下肢骨与软组织缺损[J].中华显微外科杂志,2020,43(3):233-237.
[12] 韩晓飞,孙振中,王建兵,等.Ilizarov技术骨短缩-延长治疗无血管损伤的胫骨与软组织缺损[J].中华创伤骨科杂志,2020,22(4):309-313.
[13] 马会旭,赵丽红,隆晓涛,等.Ilizarov短缩加压、再延长骨搬移术治疗创伤性股骨干骨缺损[J].中华创伤杂志,2021,37(8):708-714.
[14] 秦泗河,郭保逢,杜辉.基于Ilizarov技术的小腿延长术[J].中华骨科杂志,2021,41(11):720-726.
[15] SONG M H,KIM T J,KANG S H,et al.Low-intensity pulsed ultrasound enhances callus consolidation in distraction osteogenesis of the tibia by the technique of lengthening over the nail procedure[J].BMC Musculoskelet Disord,2019,20(1):108.
[16] 杨永康,李刚.胫骨横向骨搬移技术促进微循环再生及组织修复生物学机制的初步探索[J].中国修复重建外科杂志,2020,34(8):964-968.
[17] SPIEGELBERG B,PARRATT T,DHEERENDRA S K,et al.Ilizarov principles of deformity correction[J].Ann R Coll Surg Engl,2010,92(2):101-105.
[18] 张桢阳,丁积勇,孟永久,等.桃红四物汤加减对四肢骨折患者术后血清炎症因子及血液流变学指标的影响[J].中国中医骨伤科杂志,2020,28(11):46-48.
[19] 俞云飞,胡钢,蔡建平,等.补气活血通络方对大鼠创伤性深静脉血栓形成及血红素加氧酶-1基因表达的影响[J].中国中医骨伤科杂志,2021,29(9):5-8.
[20] 俞伟.化瘀消肿续骨汤辅助MIPPO技术治疗四肢骨折的临床效果观察[J].中国中医药科技,2019,26(1):139-141.
[21] 厉晶萍,闵晓俊,张琛.从骨科疾病的治疗谈中西医结合的发展思路[J].中国中医骨伤科杂志,2017,25(8):72-73.
[22] 张学恒.补肾接骨汤方对患者四肢骨折后的疗效及其对骨折愈合的影响[J].抗感染药学,2018,15(6):1027-1029.
[23] 谌顺清,梁伟,张雪妹,等.骨碎补化学成分和药理作用研究进展[J].中国中药杂志,2021,46(11):2737-2745.
[24] 薛纯纯,王利波,李晓锋,等.温肾阳方及其拆方通过TGF-p信号通路促进小鼠肢芽干细胞增殖与分化[J].中国中西医结合杂志,2021,41(9):1100-1105.
[25] 陈世洲,毛国庆,孙玉明,等.诸方受教授伤科经验撷英[J].中国中医骨伤科杂志,2019,27(7):75-77.

备注/Memo

备注/Memo:
基金项目:山东省中医药科技项目(2021M062)
山东省自然科学基金面上项目(ZR2020MH358)
国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号)
△通信作者 E-mail:bhz1971@163.com
更新日期/Last Update: 2022-08-15