胫骨远近端骨膜外截骨延长修复胫骨缺损的临床X线研究

目的 探讨应用环形外固定架对胫骨远近干骺端进行骨膜外截骨延长成骨的临床影像学研究.方法 收集临床治疗的44例患者并分为两组,A组经胫骨近干骺端骨膜外截骨延长,B组经胫骨远干骺端骨膜外截骨延长,术后第7天开始延长外固定架,分别于不同时段拍摄X线片观察延长区成骨,比较两组间的差异.运用Enneking系统对两组下肢功能进行评分比较,比较两组间的差异.结果 术后随访6个月～2年,在X线片上观察胫骨近干骺端截骨延长较远干骺端截骨延长早期有更为明显的成骨现象,随着时间推移,牵张间隙新生骨密度影像也由低向高增加,两组差异性逐渐减小.下肢功能两组无统计学差异.结论 环形外固定架胫骨近干骺端骨膜外截骨延长有利于早期活跃性成骨作用.

The clinical imaging study of osteogenic in tibal metaphysis of periosteal osteotomy by external fixation

Objective To investigate the clinical imaging study of the osteogenic in tibal metaphysis of periosteal osteotomy by Ilizarov external fixation.Methods Collecting 44 patients needed to treat in clinical and then divided into 2 groups,Group A：Periosteal osteotomy in the near metaphyseal of tibia.Group B：Periosteal osteotomy in the distal metaphyseal of tibia.Begin lengthening the tractor device from the 7th day.Periodic review of X-ray to observe osteogenesis of the extend area.Compare with the differences between the two groups.Scoring lower limb function between the two groups by Enneking system.Compare with the differences between the two groups.Results Patients were followed up for 6 months to 2 years,tibia lengthening in the near side of metaphysis appeared more obvious phenomenon of osteogenesis than tibia lengthening in the far side of metaphysis in X-ray.Bone mineral density also increased from low to high with time passed,the differences gradually reduced between two groups.There is no significant differences between lower limb function.Conclusion Periosteal osteotomy in the near metaphyseal of tibia by Ilizarov circular external fixator is conducive to osteogenesis actively in the early time.