胫骨延长后骨痂直径与新生骨预后关系的临床分析

目的探讨胫骨延长后骨痂直径与新生骨预后的关系.方法 1996年1月～2001年12月,对68例胫骨延长者测量达所需延长长度时的骨痂直径,计算骨痂直径率(callus diameter ratios,CDR);统计拆除外固定架后2～4周时新生骨发生骨折例数及畸形角度,比较骨折和成角畸形与CDR的关系.结果拆除外固定架前胫骨前屈角度5度以上畸形19例,其中11例发生骨折;拆除外固定架后胫骨出现5度以上畸形6例,其中2例骨折;其余43例胫骨延长骨痂正常愈合.计算CDR值:CDR值小于80% 23例,其中发生新生骨骨折13例,成角畸形5度以上者21例;CDR在81%～85%之间6例,成角畸形5度以上4例;CDR值超过86% 39例,无畸形或新生骨骨折.结论胫骨延长时CDR小于80%时,容易发生新生骨骨折和畸形;CDR大于85%时,无新生骨骨折和畸形发生;两组间具有统计学意义(P＜0.05).CDR是判断骨痂能否正常愈合较为理想的检测指标.

RELATIONSHIP BETWEEN TIBIA CALLUS DIAMETER RATIO AND PROGNOSIS DURING TIBIA LENGTHENING

Objective To investigate the relationship between the tibia callus diameter ratio(CDR) and prognosis during tibial distraction and the occurrence of late deformity or fracture. Methods We measured tibial lengthening callus diameter and added up the cases of angular deformity and fracture in 68 cases from January 1996 to December 2001, to calculated callus diameter ratios and compare the relationship between the tibia callus diameter during tibial distraction and the occurrence of late callus angular deformity or fracture. Results In 23 cases of CDR<80%, 13 cases had new bone fracture, 21 cases had angular deformity >5 degree. In 6 cases of 81%5 degree. In the other 39 cases of CDR>85%, there were no fracture and angular deformity. Conclusion When the CDR was >85%, there were no angular deformity and fracture, but when the CDR was <80%, the complications of fracture and angular deformity occur. CDR is a better alarming index for preventing the complications occurring in tibial lengthening.