一期短缩再延长技术结合接骨药丸治疗开放性胫骨骨缺损的疗效观察

Observation on the Curative Efficacy of One Stage Shortening and Extension Technique Combined with Bone-Setting Pill in Treating Open Tibial Bone Defect

目的:探讨一期短缩再延长技术结合接骨药丸治疗开放性胫骨骨缺损的疗效。方法:回顾性分析2010年1月至2020年12月收治的67例开放性胫骨骨缺损患者的病例资料,所有患者均采用一期短缩再延长技术治疗,其中33例术后常规对症治疗,为对照组;其余34例术后加服中药制剂接骨药丸治疗,为治疗组。比较两组患者在延长骨段骨密度、愈合指数及Paley骨搬运治疗骨缺损疗效评价方面的差异。结果:67例患者均获随访,随访时间12~18个月,中位数15个月,所有骨折均获愈合。两组患者术后延长骨段骨密度比较:术后4周差异无统计学意义(P>0.05);术后8周、12周及16周,差异有统计学意义(P<0.05),治疗组优于对照组。术后愈合指数比较,差异有统计学意义(P<0.05),治疗组优于对照组。术后1年按Paley骨搬运治疗骨缺损疗效评价比较,差异有统计学意义(P<0.05),治疗组优于对照组。结论:一期短缩再延长技术治疗开放性胫骨骨缺损安全有效,结合接骨药丸治疗能明显提高牵拉区的成骨质量,促进骨折端的及早愈合,缩短了治疗周期,有利于肢体功能的恢复。

Objective:To investigate the efficacy of one stage shortening and extension technique combined with bone-setting pill in treating open tibial bone defect.Methods:67patients with open tibial bone defect admitted from January 2010to December 2020were retrospectively analyzed.All patients were on the treatment of one-stage shortening and then extension technique,and 33patients were on the treatment of conventional symptomatic treatment after having surgery,which was the control group.The other 34cases were on the treatment of bone-fixing pills of Chinese medicine after having surgery,which were in the treatment group.The differences of bone mineral density(BMD),healing index(CI)and Paley bone transfer on the treatment of bone defects were compared between the two groups.Results:67patients were followed up for 12to 18months,with a median of 15months,and all fractures had healed.Comparison of postoperative extended bone segment BMD between the two groups:there was no statistically significant difference at 4weeks after surgery,but there were statistically significant differences at 8,12and 16weeks after surgery(P<0.05),and the treatment group was superior to the control group.The postoperative healing index was statistically significant(P<0.05),and the treatment group was better than the control group.One year after surgery,Paley bone transport was used to treat bone defects,and the difference was statistically significant(P<0.05).The treatment group was superior to the control group.Conclusion:It is safe and effective to treat open tibial bone defect with one stage shortening and then lengthening technique.Combined with bone-setting pill,it can obviously im-prove the quality of bone formation in the traction area,promote the early healing of fracture end,shorten the treatment period,and benefit the recovery of limb function.