环形外固定架骨搬运治疗胫骨创伤后大段骨缺损

Transosseous osteosynthesis with annular external fixator for the treatment of long bone defect after tibial traumatic

目的:探讨应用环形外固定架辅助骨搬运术治疗创伤后胫骨大段骨缺损的疗效。方法:自2002年至2011年采用骨搬运术对17例创伤性胫骨长段骨缺损进行治疗,男11例,女6例;年龄22～45岁,平均(31.00±2.35)岁。骨缺损范围5～13.1cm,平均(7.50±1.01)cm。观察外固定时间、骨性愈合时间、术后患肢延长长度。术后患肢功能恢复程度参照Paley评价标准进行功能评价。结果:全部病例获随访,时间12～48个月,平均(30.00±2.35)个月。17例患者均获得了良好的骨性愈合,骨性愈合时间为8～15个月,平均(10.10±0.59)个月;外固定时间12～16个月,平均(14.10±0.65)个月;术后患肢延长长度平均(7.50±1.01)cm。根据Paley等骨与功能分级方法评价功能,优9例,良6例,可2例。结论:骨搬运术是治疗胫骨创伤后大段骨缺损、成功重建肢体长度的有效方法,骨搬运术具有操作简单,对软组织损伤较小、软组织覆盖较简单、疗效肯定等优点,临床值得推广。

Objective ：To investigate the efficacy of the application of transosseous osteosynthesis with annular external fixator for the treatment of traumatic large bone defects of the tibia. Methods：From 2002 to 2011,17 cases of traumatic tibial long bone defect were treated by transosseous osteosynthesis with annular external fixator including 11 males and 6 females with an average age of （31.00±2.35） years old ranging from 22 to 45 years. The length of defect was from 5 to 13.1 cm with an average of （7.50±1.01） cm. The fixed time ,bone healing time and the extend length of the affected limb were observed ,and the degree of recovery of limb function after surgery were assessed ccording to the Paley＇s limb function evaluation. Results：All patients were followed up from 12 to 48 months with an average of （30.00±2.35） months,the bone defects of 17 patients achieved bone healing. The average bone healing time was （10.10±0.59） months （8 to 15 months） ;the average time of fixed time was （ 14.10±0.65 ） months （ 12 to 16 months ） ;the average extend length of the affected limb was （7.50±1.01 ） cm. The resuits of Paleys functional evaluation was excellent in 9 cases ,good in 6, fair in 2. Conclusion ：Transosseous osteosynthesis with annular external fixator is an effective method for treatment of large bone defects of the tibia. It is successful reconstruction of limb length, simple operation, less soft tissue injury, and is clinical worthy of promotion.