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牵拉成骨技术治疗下肢大段骨缺损
引用本文:王富明,陈鸿奋,陈滨,任高宏,杨运平,秦煜,王钢. 牵拉成骨技术治疗下肢大段骨缺损[J]. 中华创伤骨科杂志, 2011, 13(6). DOI: 10.3760/cma.j.issn.1671-7600.2011.06.008
作者姓名:王富明  陈鸿奋  陈滨  任高宏  杨运平  秦煜  王钢
作者单位:南方医科大学南方医院创伤骨科,广州,510515
摘    要:目的 探讨应用牵拉成骨技术治疗下肢大段骨缺损的临床疗效.方法 回顾性分析2002年8月至2010年8月收治的11例下肢大段骨缺损患者临床资料,男10例,女1例;年龄14~53岁,平均34.5岁.均行牵拉成骨治疗,右侧胫骨7例,左侧胫骨3例,右侧股骨1例;骨缺损长度5~15cm,平均8.6 cm;9例治疗已结束,2例仍处于矿化阶段.结果 所有患者术后获7~48个月(平均27.3个月)随访.9例治疗结束患者,平均骨愈合指数为1.99个月/cm;根据Paley评价系统评价骨性结果:优6例,良3例,优良率为100%;功能结果:优4例,良4例,一般1例.结论应用牵拉成骨技术治疗大段骨缺损,手术操作简单,尤其是对于单纯骨干缺损患者,采用单边外固定支架治疗,且其手术操作更为简洁.
Abstract:
Objective To discuss the therapeutic effect of distraction osteogenesis for large bone defect of the lower extremity. Methods From August 2002 to August 2010, 11 patients with large bone defect at the lower extremity were treated with distraction osteogenesis. They were 10 men and one woman, aged from 14 to 53 years (average, 34. S years). The defect was at the right tibia in 7 cases, left tibia in 3 cases and right femur in one case. The lengths of bone defect ranged from 5 to 15 cm (average, 8. 6 cm). Results The patients were followed up for 7 to 48 months, with a mean period of 27. 3 months. The treatment of 9 cases was over, with a mean healing index of 1. 99 months/cm. According to the Paley evaluation system, the bony results were excellent in 6 and good in 3 patients; the functional results were excellent in 4, good in 4, and fair in one patient. Two cases were still in the mineralization period. Conclusion Treatment of large bone defects with distraction osteogenesis is simple and can obtain satisfactory therapeutic effects, especially when a monolateral external fixator is used for the simple shaft bone defect.

关 键 词:胫骨  股骨  外固定器  骨缺损

Distraction osteogenesis for large bone defect of the lower extremity
Abstract:Objective To discuss the therapeutic effect of distraction osteogenesis for large bone defect of the lower extremity. Methods From August 2002 to August 2010, 11 patients with large bone defect at the lower extremity were treated with distraction osteogenesis. They were 10 men and one woman, aged from 14 to 53 years (average, 34. S years). The defect was at the right tibia in 7 cases, left tibia in 3 cases and right femur in one case. The lengths of bone defect ranged from 5 to 15 cm (average, 8. 6 cm). Results The patients were followed up for 7 to 48 months, with a mean period of 27. 3 months. The treatment of 9 cases was over, with a mean healing index of 1. 99 months/cm. According to the Paley evaluation system, the bony results were excellent in 6 and good in 3 patients; the functional results were excellent in 4, good in 4, and fair in one patient. Two cases were still in the mineralization period. Conclusion Treatment of large bone defects with distraction osteogenesis is simple and can obtain satisfactory therapeutic effects, especially when a monolateral external fixator is used for the simple shaft bone defect.
Keywords:Tibia  Femur,External fixations  Bone defect
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