Ilizarov环形外固定架与Orthofix单边外固定架治疗胫骨大段骨缺损的疗效分析

Efficacy analysis of Ilizarov ring external fixator and Orthofix unilateral external fixator in the treatment of large segmental tibial bone defect

目的 探讨Ilizarov环形外固定架与Orthofix单边外固定架治疗胫骨大段骨缺损的疗效。方法 选取2020年2月至2021年6月金华文荣医院收治的112例胫骨大段骨缺损患者为研究对象,采用随机数字表法分为对照组和观察组,每组各56例。对照组采用Orthofix单边外固定架治疗,观察组采用Ilizarov环形外固定架治疗,比较两组患者的出血量、骨延长长度、延长期骨矿化时间、带架时间、愈合时间、手术时间、优良率、并发症发生率。结果 两组患者的术中出血量、骨延长长度、延长期骨矿化时间、带架时间、愈合时间比较,差异无统计学意义(P>0.05),但观察组手术时间更长(P<0.05),两组患者术后1个月优良率比较,差异无统计学意义(χ^(2)=0.146,P=0.703),但观察组术后3个月、6个月的优良率均高于对照组(χ^(2)=4.568,P=0.033;χ^(2)=4.747,P=0.029),观察组患者术后并发症发生率明显低于对照组(χ^(2)=5.617,P<0.05)。结论 Ilizarov、Orthofix外固定架均可促进胫骨大段骨缺损患者的术后踝关节功能恢复,但Ilizarov环形外固定架疗效更好,术后并发症概率更小。

Objective To explore the efficacy of Ilizarov ring external fixator and Orthofix unilateral external fixator in the treatment of large segmental tibial bone defects.Methods From February 2020 to June 2021,112 patients with large tibial bone defects in Jinhua Wenrong Hospital were selected as the study subjects,they were divided into observation group and control group by random number table method,with 56 cases in each group.The control group was treated with Orthofix unilateral external fixator,and the observation group was treated with Ilizarov annular external fixator.The bleeding volume,bone lengthening length,bone mineralization time in the extended period,frame time,healing time,operation time,excellent rate and complication rate of the two groups were compared.Results There was no statistically significant difference between the two groups in the amount of intraoperative bleeding,the length of bone lengthening,the bone mineralization time in the extended period,the time of wearing frame,and the healing time(χ^(2)=0.146,P=0.703),but the excellent and good rate of the observation group at 3 and 6 months after operation was higher than that of the control group(χ^(2)=4.568,P=0.033;χ^(2)=4.747,P=0.029),the incidence of postoperative complications in the observation group was significantly lower than that in the control group(χ^(2)=5.617,P<0.05).Conclusion Both Ilizarov and Orthofix external fixator can promote the recovery of ankle joint function after operation,but for patients with large tibial bone defect,the use of Ilizarov ring external fixator is more effective,and the probability of postoperative complications is lower.