Ilizarov骨迁移治疗胫骨大段骨缺损的临床疗效

Ilizarov technique in the treatment of long segmental bone defect of tibia

目的探讨Ilizarov外固定骨牵移技术治疗胫骨节段性骨缺损的临床疗效。方法采用Ilizarov外固定骨迁移方法治疗21例胫骨大段骨缺损患者。结果手术时间70～95(75±4.2)min。21例均获随访,时间14～30(17.6±6.5)个月。骨牵移长度为6～10(7±4.2)cm。骨痂矿化时间为11～20(12.1±3.5)周,外固定支架固定时间为12～20(14.9±3.3)个月,其中2例出现马蹄足畸形,给予跟腱延长;1例出现骨不连,予断端清理髂骨植骨后愈合;2例出现钉道不同程度的感染,给予清创后愈合。疗效按Johner-Wruh标准进行评定:优10例,良7例,差4例。结论 Ilizarov外固定骨牵移治疗胫骨大段骨缺损疗效较满意。

Objective To investigate the clinical efficacy of the Ilizarov external fixation bone transportation in the treatment of tibial segmental bone defects. Methods 21 cases with long segmental bone defect of tibia were treated by using Ilizarov bone transportation. Results The operative time was 70 - 95 （75 ± 4. 2 ） rain. All patients were followed up for 14 -30 （ 17.6-±6. 5） months. Bone transportation length was 6 - 10 （7 ±4. 2） cm. Callus minerali- zation time was 11 - 20 （ 12.1± 3.5） weeks, external fixation time was 12 - 20 （ 14. 9 ± 3.3 ） months, 2 cases of clubfoot deformity which were given Achilles tendon extend; 1 ease nonunion which were given iliac bone graft; 2 ca- ses of pin tract infection which were given debridement. The results were evaluated by the Johner-Wruh standard： ex- cellent in 10 cases, good in 7, and poor in 4. Conclusions Ilizarov external fixation bone transportation is effective in the treatment of tibial segmental bone defects.