一期骨搬移治疗胫骨开放性骨折伴骨缺损

目的探讨急诊一期行骨短缩-延长骨搬移治疗胫骨开放性骨折伴骨缺损与常规分期手术治疗的优缺点。方法随机选择胫骨开放性骨折伴骨缺损60例,分成A组（一期骨短缩延长治疗组）和B组（常规分期手术治疗组）,A组根据Ilizarov牵张成骨理论,采用可同时短缩延长型外固定架进行断端的加压短缩、干骺端的截骨延长一期修复骨缺损;B组常规一期清创外固定、二期修复骨缺损治疗,比较住院时间、手术次数、平均住院费用、平均骨愈合时间、感染概率、取髂骨植骨率、患者满意率。结果 A组住院时间、手术次数、平均住院费用、平均骨愈合时间、感染概率、取髂骨植骨率均少于B组,患者满意率高于B组。结论急诊一期骨搬移治疗胫骨开放性骨折伴骨缺损,选择合适病例,掌握好适应证,应用价值更高。

Treatment of Open Tibia Fracture with Bore Defect with Bone Trasport

Objective To compare the clinical outcomes of primary bone transport operation with staging opera- tion in treating open tibial fracture combined with bone defect of emergency. Methods 60 emergency cases of open tibial fracture combined with bone defect were divided into 2 groups randomly. Patients in group A were treated with primary bone transport operation according to Ilizarov＇s distraction osteogenesis theory,while in group g with one- stage debridement and secondary operation for bone defect. We compared the Length of Stay,number of operations, hospitalization expenses, healing time, incidence of complication, bone graft and patients~satisfaction. Results The Length of Stay,number of operations ,hospitalization expenses ,healing time ,incidence of complication,bone graft in A group were much less than in B group （P〈0.05）,while incidence of patients~satisfaction in A group is significantly higher（P〈0.05）. Conclusion Primary bone transport operation is more suitable for emergency cases of open tibial fracture combined with bone defect in condition of controlling the indication.