骨搬移与同侧带蒂腓骨转移治疗慢性胫骨骨髓炎伴长段骨缺损的疗效比较

目的 对比分析骨搬移技术与同侧带蒂腓骨转移治疗慢性胫骨骨髓炎伴长段骨缺损的临床疗效。方法 选择2016年2月—2017年8月于本院接受治疗的慢性胫骨骨髓炎伴长段骨缺损患者共66例,依随机数字表法分为观察组(33例)与对照组(33例)。对照组采用同侧带蒂腓骨转移治疗,观察组则采用骨搬移技术治疗。对比两组术后恢复指标(骨性愈合时间、外固定架放置时间)与手术前后Baird-Jackson踝关节功能评分、美国特种外科医院膝关节评分(HSS)。结果 术后观察组骨性愈合时间与外固定架放置时间(6.34±0.62)月、(7.42±0.38)月]均短于对照组(7.68±0.78)月、(8.82±0.52)月],(t值分别为7.726、12.487,P值均<0.05);术后,观察组Baird-Jackson、HSS评分分别为(83.17±7.56)分、(85.36±6.85)分,高于对照组的(75.48±8.15)分、(77.25±8.04)分,(t值分别为3.974、4.411,P值均<0.01)。结论 骨搬移技术治疗慢性胫骨骨髓炎伴长段骨缺损的临床效果优于同侧带蒂腓骨转移,前者能有效促进患者恢复,提高踝关节与膝关节的功能。

Comparison of bone transfer and ipsilateral pedicled fibula metastasis in treatment of chronic tibial osteomyelitis with long segment bone defect

Objective To compare the clinical efficacy of bone transfer technique and ipsilateral pedicled fibular metastasis in the treatment of chronic osteomyelitis of tibia with long segment bone defect. Methods From February 2016 to August 2017, 66 patients with chronic osteomyelitis of tibia with long segment bone defects were randomly divided into a trial group (n=33) and a control group (n=33). The control group was treated with ipsilateral pedicled fibular metastasis, while the trial group was treated with bone transfer technique. The postoperative recovery indexes (bone healing time and external fixation time) and the Baird-Jackson ankle function score, and the American special surgery hospital (HSS) knee joint score before and after the operation were investigated and compared between the two groups. Results The average bone healing time and external fixation time in the trial group were (6.34±0.62) months and (7.42±0.38) months respectively, which were significantly shorter than those in the control group , and there were significant differences (both P<0.05). The average Baird-Jackson score and HSS score in the trial group were (83.17±7.56) points and (85.36±6.85) points respectively, which were significantly higher than those in the control group , and the differences were statistically significant (both P<0.05). Conclusion The clinical effect of the bone transfer technique in the treatment of chronic tibia osteomyelitis with long segment bone defect is superior to that of the ipsilateral pedicled fibular metastasis. The former can effectively promote the recovery of patients and improve the functions of ankle joint and knee joint.