[1]李树源 周琦石△ 陈超 陈家齐 周宏亮.诱导膜技术与骨搬运技术治疗胫骨创伤性骨髓炎的疗效比较[J].中国中医骨伤科杂志,2019,27(01):17-21.
　LI Shuyuan ZHOU Qishi CHEN Chao CHEN Jiaqi ZHOU Hongliang.Effects of Induced Membrane Technique and Bone Transport Technique in the Treatment of Traumatic Osteomyelitis of the Tibia[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2019,27(01):17-21.
点击复制

诱导膜技术与骨搬运技术治疗胫骨创伤性骨髓炎的疗效比较()
分享到：

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

卷:
第27卷
期数:
2019年01期
页码:
17-21
栏目:
临床研究
出版日期:
2019-01-15

文章信息/Info

Title:
Effects of Induced Membrane Technique and Bone Transport Technique in the Treatment of Traumatic Osteomyelitis of the Tibia
文章编号:
1005-0205(2019)01-0017-05
作者:
李树源1 周琦石1△ 陈超1 陈家齐1 周宏亮1
广州中医药大学第一附属医院(广州,510405)
Author(s):
LI Shuyuan1 ZHOU Qishi1△ CHEN Chao1 CHEN Jiaqi1 ZHOU Hongliang1
The First Hospital, Affiliated to Guangzhou University of Traditional Chinese Medicine, Guangzhou 510080, China.
关键词:
诱导膜技术;  骨搬运技术;  创伤;  骨髓炎
Keywords:
Masquelet technique;  Ilizarov technology;  Trauma;  Osteomyelitis
分类号:
R681.7
文献标志码:
A
摘要:
对比采用诱导膜技术(Masquelet技术)与Ilizarov骨搬运技术治疗胫骨创伤性骨髓炎的临床疗效。方法:回顾分析2011年1月至2018年9月本院创伤骨科收治的29名胫骨创伤性骨髓炎患者的临床资料,其中采用Masquelet技术治疗组15例(A组),采用Ilizarov技术治疗组14例(B组)。术后对比两组患者的骨临床愈合时间、愈合率、下肢完全负重时间、并发症的发生率、膝、踝关节功能评分、骨痂评分、术后疼痛视觉模拟评分(VAS)等情况。结果:两组患者的术后膝、踝关节功能评分、骨痂评分以及愈合率差异无统计学意义(P>0.05),而Masquelet技术组在骨临床愈合时间、下肢完全负重时间、并发症的发生率、术后疼痛视觉模拟评分方面,均优于Ilizarov组,差异有统计学意义(均P<0.05)。结论:采用Masquelet技术治疗胫骨创伤性骨髓炎优势明显,可以缩短骨愈合时间,减轻术后疼痛,减少并发症发生率。
Abstract:
To compare the clinical efficacy of inducing membrane technique(Masquelet technique)and Ilizarov bone transport technique in the treatment of traumatic osteomyelitis of the tibia. Methods: The clinical data of 29 patients with traumatic osteomyelitis admitted to our hospital from January 2011 to September 2018 were retrospectively analyzed. Among them, 15 patients were in the treatment group with Masquelet technique(group A,)and 14 patients were in group treated with Ilizarov technique(group B,). The clinical healing time, healing rate, total weight-bearing time of the lower limbs, incidence of complications, knee and ankle function scores, osteophyte scores, and postoperative pain visual analogue scale(VAS)were compared between the two groups.Results There were no significant differences in knee and ankle scores, osteophyte scores, and healing rates between the two groups(P>0.05). The Masquelet technique group was superior to the Ilizarov group in the time of bone healing time, total weight-bearing time of the lower limbs, incidence of complications, and postoperative pain visual analogue scale(VAS)(both P<0.05). Conclusion: The use of Masquelet technology for treating tibiofibular osteomyelitis is obvious effective and advantageable, which can shorten the time of bone healing and reduce postoperative pain and complications.

参考文献/References:

[1] PELISSIER P,B01LECKER V,MARTIN D,et al.Foot reconstmction with the bj-Masquele,procedure[J].Ann Chir Plast Esthet,2002,47(4):304-307.
[2] TATSUMI R L.Lateral pressure and VAS pain score analysis for the lat-eral lumbar interbody fusion procedure[J].Int Spine Surg,2015,9:48.
[3] MERCHANT T C,DICTZ F R.Long-term follow-up after fractures of the tibia and fibular shafts[J].J Bone Joint Surg Am,1989,71(4):599-606.
[4] ARONSON J.Limb-lengthening,skeletal reconstruction,and bone transport with the Ilizarov method[J].J Bone Jt Surg Am,1997,79(8):1243-1258.
[5] LLIZAROV G A.The tension-stress effect on the genesis and growth of tissues:Part Ⅱ.the influence of the rate and frequency of distraction[J].Clin Orthop Relat Res,1989,239:263-285.
[6] ILIZAROV G A.The tension-stress effect on the genesis and growth of tissues:Part Ⅰ.the influence of stability of fixation and soft-tissue preservation[J].Cliu Orthop Relat Res,1989,238:249-281.
[7] PAPAKOSTIDIS C,BHANDARI M,GIANNOUDIS P V.Distraction osteogenesis in the treatment of long bone defects of the lower limbs:efectiveness,complications and clinical results; a systematic review and meta-analysis[J].Bone Jt J,2013,95-B(12):1673-1680.
[8] SAHU R L,RANJAN R.Treatment of complex nonunion of the shaft of the tibia using Ilizarov technique and its functional outcome[J].Niger Med J,2016,57(2):129-133.
[9] 殷渠东,孙振中,顾三军,等.骨搬运与骨短缩-延长治疗胫骨骨缺损合并软组织缺损的疗效比较[J].中国修复重建外科杂志,2014,28(7):818-822.
[10] BRITTEN S,GHOZ A,DUFFIELD B,et al.Ilizarov fixator pin site care:the role of crusts in the prevention of infection[J].Injury,2013,44(10):1275-1278.
[11] SIMPSON A H,HALLIDAY J,HAMILTON D F,et al.Limb lengthening and peripheral nerve function-factors associated with deterioration of conduction[J].Acta Oahop,2013,84(6):579-584.
[12] EL-GAMMAL T A,SHIHA A E,EL-DEEN M A,et al.Management of traumatic tibial defects using free vascularized fibula or Ilizarov bone transport:a comparative study[J].Microsurg,2008,28(5):339-346.
[13] MASQUELET A C.Muscle reconstruction in reconstructive sur-gery:soft tissue repair and long bone reconstruction[J].Langen Beck's Archives of Surgery,2003,388(5):344-346.
[14] MASQUELET A C,BEGUE T.The concept of induced membrane for reconstruction of long bone defects[J].Orthop Clin North Am,2010,41(1):27-37.
[15] PENNER M J,DUNCAN C P,MASRI B A.The mitelution characteistics of antibiotic-loaded CMW and palacos:bone cements[J].Arthroplasy,1999,14(2):209-214.
[16] WOON C Y,CHONG K W,WONG M K.Induced mem-branes-a staged technique of bone-grafting for segmental boneloss:a report of two cases and a literature review[J].The Journal of Bone and Joint Surgery,2010,92(1):196-201.
[17] PELISSIER P,MASQUELET A C,BAREILLE R,et al.Induced membranes secrete growth factors includingvascular and osteoinductive factors and could stimulate boneregeneration[J].Journal of Orthopaedic Research,2004,22(1):73-79.
[18] APARD T,BIGORRE N,CRONIER P F,et al.Two-stage reconstruction of post-traumatic segmental tibia bone loss with nailing[J].Orthopaedics and Traumatology:Surgery and Research,2010,96(5):549-553.
[19] WONG TM,LAU TW,LI X,et al.Leung F.Masquelet technique for treatment of posttraumatic bone defects[J].Scientific World Journal,2014:710302.
[20] TONG K,ZHONG Z,PENG Y,et al.Wang G.Masquelet technique versus Ilizarov bone transport for reconstruction of lower extremity bone defects following posttraumatic osteomyelitis[J].Injury,2017,48(7):1616-1622.
[21] 孙志波,郭骏,陈荣,等.Masquelet技术与Ilizarov技术治疗成人胫骨慢性骨髓炎的早期临床疗效比较[J].骨科,2017,8(5):349-353.
[22] GIANNOUDIS P V,FAOUR O,GOFF T,et al.Masquelet technique for the treatment of bone defects:tips-tricks and future directions[J].Injury,2011,42(6):591-598.

备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(81674001) 1广州中医药大学第一附属医院(广州,510405) △通信作者 E-mail:2410685058@qq.com
更新日期/Last Update: 2019-01-15