95例髋臼骨折术后异位骨化局部单次放疗联合药物治疗对术后复发的预防效果

Protective effect of local single radiation combined with drug therapy ontreatmentof 95 patients with heterotopic ossification after acetabulum fracture operation

目的观察髋臼骨折术后异位骨化局部单次放疗联合药物治疗对术后复发的预防效果。方法 50例髋臼骨折者设为髋臼骨折组,45例髋臼骨折术后异位骨化者设为异位骨化组。髋臼骨折组行切开复位内固定术,异位骨化组行骨化切除术。比较2组相关临床指标。结果髋臼骨折组患者平均随访19.3个月。X线提示发生异位骨化8例,异位骨化发生率为16.0%,严重异位骨化发生率为2.0%;异位骨化组患者平均随访时间23.4个月。X线提示异位骨化复发6例。异位骨化组OHS评分较治疗前显著改善(P<0.01)。2组患者治疗期间均未出现明显不良反应。结论吲哚美辛联合局部单次放疗可降低髋臼骨折术后异位骨化的发生率以及异位骨化的严重程度,还能降低异位骨化切除术后的复发率。

Objective To observe protective effect of local single radiation combined with drug therapy on treatment of patients with heterotopic ossification after acetabulum fracture operation.Methods Fifty patients with acetabulum fracture were designed as acetabulum fracture group and treated with open reduction and internal fixation,while 45 patients with heterotopic ossification were designed as ectopic ossification group and treated with heterotopic ossification resection. Clinical indexes were compared between two groups. Results In the acetabulum fracture group,all patients got follow- up of 19. 3 months averagely. X- ray showed that heterotopic ossification was observed in 8cases,and the rate of heterotopic recurrence was 16. 0%,and incidence rate of serious heterotopic ossification was 2. 0%. In the heterotopic ossification group,all patients were followed up for 23. 4months averagely. X- ray showed that heterotopic ossification recurrence was observed in 6 cases,and the OHS score improved significantly when compared with that before treatment（ P〈 0. 01）. No severe adverse reactions were occurred during treatment in both groups. Conclusion Indomethacin combined with local radiotherapy can not only decrease the occurrence rate of heterotopic ossification after acetabulum fracture and extent of heterotopic ossification,but also can reduce recurrence rate of heterotopic ossification after resection.