摘要
目的探讨：二处戡骨骨搬移治疗胫骨大段骨缺损合并软组织缺损的疗效及其加速骨和软组织愈合的If能性。方法2009年5月至2011年5月共收治6例胫骨大段骨缺损合并软组织缺损患者，均为男性；年龄20～51岁，平均34．5岁。致伤原因：交通伤5例，机器压砸伤1例。均为GustiloⅢB型歼放性骨折．小腿胫前软组织缺损面积为8cm×4em～24cm×11cm，胫骨缺损长度为8～18cm。清创后采刷半环槽外固定支架固定，胫骨上、下干骺端截骨骨搬移治疗骨缺损和软组织缺损。术后每侧截骨端骨搬移速度为1mm／d，直至搬移骨折端对合，本组患者搬移所需时间为40～100d，平均66．6d结果6例患者术后获10～36个月（平均16个月）随访。小腿软组织缺损愈合，骨缺损均获重建，4例患者双下肢等长，2例患肢肢体长度较健侧短缩1．5cm。软组织愈合时间为60—180d，平均103d；骨愈合时间为12—31个月，平均19．3个月。所有患者牵拉结束后，未发现骨不连和骨痂愈合过快而无法继续牵拉成骨的现象，均不需要植骨。结论二处截骨骨搬移不但可有效治疗胫骨大段骨缺损合并软组织缺损，而且可加快骨搬移和软组织愈合的速度。
Objective To explore bone lengthening after two-site osteotomy for the treatment of massive bone and soft tissue defects of the tibia. Methods From May 2009 to May 2011, we treated 6 cases of massive bone and soft tissue defects of tile tibia. They were all males, aged from 20 to 51 years （average. 34.5 years）. Five of them were injured in a traffic accident and one was crushed by machinery. All injuries were open fractures of （,ustilo type IIIB. The soft tissue defects at the anterior leg ranged from 4 cm × 8 cm to 11 cm ×24 cm. and the tibial defects ranged from 8 to 18 cm. After debridement, the tibia was stabilized by a half-ring external fixator. Two osteotomies were made on the proximal and distal metaphyses of the tibia before bone lengthening was conducted at a speed of 1 mm/d at each osteotomy site. The bone lengthening lasted from 40 to 100 days, averaging 66. 6 days. Results The 6 patients were followed up from 10 to 36 months （average, 16 months）. The soft tissue defects at the leg were healed and the bone de- fects reconstructed. Four patients obtained isometric length between the 2 legs and 2 got a length discrepancy of 1.5 cm between the 2 legs. The soft tissue defects healed after 60 to 180 days （average, 103 days） and bone union was achieved ＇after 12 to 31 months （average, 19.3 months）. Bone lengthening continued snmothly without nonunion or ton rapid callus formation. No bone grafting was needed. Conclusion Bone lengthening after two-site osteotomy may effectively accelerate the healing of massive bone and sort tissue de- fects of the tibia.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2012年第10期831-834,共4页
Chinese Journal of Orthopaedic Trauma
关键词
胫骨骨折
软组织损伤
骨延长术
骨移植
Tibial fractures
Soft tissue injuries
Bone lengthening
Bone transplantation
