经皮骨断端削切+延长加压术用于下肢创伤性骨折后不愈合的临床研究

Clinical study of bone cutting plus prolongation for nonunion after traumatic fracture of lower extremity

目的观察经皮骨断端削切+延长加压术治疗下肢创伤性骨折后不愈合的临床价值。方法河南洛阳正骨医院骨科收治98例下肢创伤性骨折后不愈合患者,按随机数字表法分为观察组与对照组,各49例。对照组采取自体骨移植治疗,观察组采取经皮骨断端削切+延长加压术。比较两组骨折愈合率、一期愈合率、骨折愈合时间、术后并发症总发生率。结果观察组的骨折愈合率与一期愈合率分别为97. 96%与91. 84%,对照组分别为95. 91%与85. 71%,差异无统计学意义(P> 0. 05)。观察组骨折愈合时间为(4. 71±1. 59)个月,显著少于对照组(5. 42±1. 86)个月(P <0. 05)。观察组术后并发症总发生率为10. 20%,显著低于对照组26. 53%(P <0. 05)。结论经皮骨断端削切+骨延长加压术治疗下肢创伤性骨折后不愈合可取得较高骨折愈合率,且愈合速度快,术后并发症少,效果优于自体骨移植,值得推广。

Objective To observe the clinical value of bone cutting and prolongation compression in the treatment of non-union of traumatic fracture of lower extremity.Methods A total of98patients with nonunion of traumatic fractures of the lower extremities were prospectively studied.According to the random number table,the patients were divided into observation group and control group,with49cases in each group.The control group received autologous bone graft treatment,and the observation group received bones cut+extended compression surgery.The fracture healing rate,primary healing rate,fracture healing time and total postoperative complication rate were compared between the two groups.Results The fracture healing rate and primary healing rate in the observation group were97.96%and91.84%,respectively,while those in the control group were95.91%and85.71%,respectively,with no significant difference(P>0.05).The fracture healing time in the observation group was(4.71±1.59)months,which was significantly shorter than that in the control group(5.42±1.86)months(P<0.05).The total incidence of postoperative complications in observation group was10.20%,which was significantly lower than in control group(26.53%,P<0.05).Conclusion Percutaneous bone end cutting plus bone extension and compression is a good method to treat nonunion of traumatic fractures of the lower extremities,which results in a higher rate of fracture healing,faster healing and less postoperative complications,and is more effective than autologous bone graft.