骨应力刺激仪叩击治疗促进小腿骨干骨折术后骨愈合的前瞻性研究

Postoperative rapping by bone stress stimulator on bone healing following shaft fracture of lower leg

目的观察和评价骨应力刺激仪叩击治疗促进小腿骨干骨折术后骨愈合的疗效和临床应用价值。方法对2008年1月至2009年12月收治的92例小腿骨干骨折术后患者进行前瞻性研究，随机分为骨应力刺激仪叩击治疗组（叩击组）和术后常规处理、不予叩击治疗组（对照组），每组46例。记录并比较两组患者的I临床愈合时间、完全负重时间、患肢视觉模拟评分（VAS）、X线骨痂生长Lahe-Sandhu评分、骨延迟愈合率及骨不愈合率情况。结果所有患者均获12～18个月（平均14个月）叩击组和对照组临床愈合时间分别为（88．8±8．8）d、（107．9±9．0）d，完全负重时间分别为（104．1±9．8）d、（113．2±13．4）d，以L指标两组比较差异均有显著性统计学意义（P〈0．05）；3、6、12个月时VAS评分和x线骨痂生长Lane．Sandhu评分两组比较差异均有统计学意义（P〈0．05）；叩击组和对照组6个月时骨延迟愈合率分别为8．7％、28．3％，12个月时骨不愈合率分别为4．3％、17．4％，两组问比较差异均有统计学意义（P〈0．05）。结论骨应力刺激仪叩击治疗可加速骨痂生长，促进骨折愈合，降低骨延迟愈合和骨不愈合的发生率，可作为下肢骨折内固定术后的辅助治疗手段，具有较好的临床应用价值。

Objective To evaluate the rehabilitative effect of postoperative rapping l）y a self-designed bone stress stimulator on bone healing following shaft fracture of the lower leg. Methods Between January 2008 to December 2009, a total of 92 patients with shaft fracture of lower leg were randomly assigned into 2 even groups after surgery, one study group receiving rapping rehabilitation by a bone stress stimulator and one control group receiving conventional management without a hone stress stinmlator. The healing time, full weight bearing time, visual analogue scale scores, Lane-Sandhu scores on radiographs at 3, 6, 12 months, and rates of delayed union and non-union at 6 and 12 months were recorded and compared between the 2 groups. Results The patients were followed up for 12 to 18 months （average, 14 months） . The healing time and full weight bearing time were 88.8 ± 8.8 days and 104. 1 ± 9.8 days in the study group, significantly shorted than those in the control group （ 107.91 ± 9.03 days and 113.24 ±13.4 days） （ P 〈0. 05） . The visual analogue scale scores and Lane-Sandhu scores at 3, 6, 12 months were significant different between the 2 groups （P 〈 0.05） . At 6 and 12 months, the rates of delayed union and non-union were 8.7% and 4.3% in the study group, significantly lower than those in the control group （28.3% and 17.4% ） （ P 〈 0. 05）. Conclusion Since rapping by bone stress stimulator is effective on promotion of callus formation and bone healing and as well on reduction of delayed union or non-union, it can be used as a complementary rehabilitation for lower extremity fractures following internal fixation.