胫骨近端与远端骨搬移治疗骨髓炎骨缺损的比较

Comparison of proximal and distal tibial transportation for bone defect secondary to osteomyelitis

[目的]探讨胫骨近端与远端骨搬运在骨髓炎治疗中的疗效差异。[方法]选取本院60例慢性胫骨骨髓炎患者作为研究对象,分为近端和远端截骨搬运组,对比两组患者的下床时间、带架时间、带架期间VAS评分、疗效、EFI评分、AOFAS评分、ROM评分以及术后出现的不良反应。[结果]近端截骨搬运组患者的下地时间、带架期间的VAS评分和马蹄内翻足畸形出现比例显著低于远端组。近端截骨搬运组患者的AOFAS值和ROM值显著高于远端组患者。近端截骨搬运组患者的治疗有效率显著高于远端组。[结论]近端截骨搬运手术能显著增加足踝关节的活动度,降低出现马蹄内翻足畸形的风险,临床疗效好。

[Objective] To explore the differences between the proximal and the distal tibia transportation for bone defect secondary to osteomyelitis. [Method] A total of 60 patients who received bone transportation for chronic tibial osteomyelitis in our hospital were enrolled in this study. Based on the concrete condition, they were divided into proximal and distal osteotomy and transport groups. The bed time,time spent with frame, VAS score, EFI score with frame, AOFAS score, range of motion and adverse reactions after surgery were compared between the two groups. [Results] The proximal group proved significantly more efficient than the distal group, the former consumed significantly shorter time to return ambulation and remove frame, associated with significantly lower VAS score and incidence of foot drop than the latter. However, the proximal group was significantly superior to the distal group in AOFAS and ROMs. [Conclusion] Proximal osteotomy and bone transportation is considerably superior to the distal counterpart in curative outcomes, such as mobility of the ankle joint, and risk of foot drop.