Genex人工骨与自体髂骨治疗SchatzkerⅡ型胫骨平台骨折骨缺损的比较分析

Comparison of Genex artificial bone and autologous iliac bone in treatment of SchatzkerⅡtibial plateau fracture bone defects

目的通过与自体髂骨比较,评价Genex人工骨在治疗SchatzkerⅡ型胫骨平台骨折骨缺损中的疗效。方法回顾性分析2015年1月至2018年12月南华大学附属第二医院治疗SchatzkerⅡ型胫骨平台骨折120例,其中65例Genex人工骨组使用Genex人工骨,55例自体髂骨组使用自体髂骨。比较两组术中失血量、手术时间、术后第1天视觉模拟评分(VAS)、终末随访时VAS评分、终末随访时Lysholm膝关节评分、终末随访时关节面塌陷程度,骨折愈合情况。结果Genex人工骨组术中失血量少于自体髂骨组,手术时间短于自体髂骨组,术后第1天VAS评分低于自体髂骨组,差异有统计学意义(P<0.05)。两组患者在终末随访时VAS评分及膝关节Lysholm评分比较,差异无统计学意义(P>0.05)。终末随访Genex人工骨组关节面塌陷程度明显少于自体髂骨组,差异有统计学意义(P<0.05)。终末随访时,两组患者骨折均全部愈合。结论Genex人工骨治疗SchatzkerⅡ型胫骨平台骨折的临床疗效与自体骨相当,但在防止关节面下沉,减少手术时间及改善术后疼痛方面可能更具优势。

Objective To evaluate the efficacy of Genex artificial bone in the treatment of SchatzkerⅡtibial plateau fracture bone defects by comparing with autologous iliac bone.Methods A retrospective case study analysis of 120 patients with SchatzkerⅡtibial plateau fractures treated in the Second Hospital of University of South China from January 2015 to December 2018 was conducted.65 patients in the Genex group received the Genex artificial bone and 55 patients in the autogenous iliac bone group received the autogenous iliac bone.The intraoperative blood loss,operation time,visual analogue scale(VAS)score at 1 day after operation,VAS score at the end of follow-up,Lysholm knee score at the end of follow-up,degree of articular surface re-collapse at the end of follow-up,and fracture healing were compared between the two groups.Results The intraoperative blood loss in the Genex artificial bone group was less than that in the autogenous iliac bone group,the operation time was shorter than that in the autogenous iliac bone group,and the VAS score on the first postoperative day was lower than that in the autogenous iliac bone group,with statistically significant differences(P<0.05).There were no statistically significant differences in VAS score and Lysholm knee score between the two groups at the end of follow-up(P>0.05).At the end of follow-up,the degree of articular surface re-collapse in the Genex artificial bone group was significantly less than that in the autogenous iliac bone group,with statistically significant difference(P<0.05).At the end of follow-up,the fractures in the two groups were all healed.Conclusion The clinical efficacy of Genex artificial bone is equivalent to that of autogenous bone in the treatment of SchatzkerⅡtibial plateau fractures.However,it may have advantages in preventing articular surface subsidence,reducing operation time,and relieving postoperative pain.