摘要
目的胫骨骨缺损患者骨搬运手术治疗效果受较多因素影响,本研究分析影响胫骨骨缺损患者骨搬运手术疗效的相关因素,为制定胫骨骨缺损骨搬运手术方案提供依据。方法选择2015-02-01-2017-02-01中国平煤神马医疗集团总医院接受骨搬运手术治疗的20例胫骨骨缺损患者作为研究对象,全部患者均接受相同的手术方式治疗,将术后存在断端骨不愈合、软组织嵌顿和断端对线不良者视为无效者,纳入可能的危险因素,经χ2检验与非条件多项Logistic回归分析检验可能的影响因素。结果全部患者术后均完成骨搬运,术后外固定架的使用时间为220d,在骨搬运期间皮肤均自然愈合。在治疗期间,20例患者中出现12例骨不愈合者,占60.00%;8例软组织嵌顿者,占40.00%;5例对线不良者,占25.00%。单因素分析结果显示,软组织条件是胫骨骨缺损患者骨搬运手术断端骨不愈合(χ2=4.592,P=0.032)和软组织嵌顿(χ2=4.201,P=0.040)的影响因素。非条件多项Logistic回归分析结果显示,软组织条件差是导致胫骨骨缺损患者骨搬运手术治疗发生断端不愈合(OR=15.000,95%CI为1.652~136.172,P=0.016)和软组织嵌顿(OR=9.800,95%CI为0.889~106.845,P=0.040)的危险因素。结论胫骨骨缺损患者经骨搬运技术治疗后断端骨不愈合、软组织嵌顿和对线不良等时有发生,可能受患者软组织条件等因素影响,在治疗期间软组织条件差者应引起骨科医生重视。
OBJECTIVE The treatment effect of tibial bone defect patients is affected by many factors.The related factors that influence the effect of tibial bone defect surgery on patients were analyzed to guide the formulation of future tibial bone defect surgery protocols.METHODS A total of 20 patients with tibial bone defects who underwent bone transport surgery in General Hospital of China Pingmei Shenma Medical Group were selected from February 1,2015 to February 1,2017.All patients received the same surgical treatment.Those with soft tissue incarceration and bad end alignment were regarded as invalid,and the possible risk factors were included.The possible influence factors were found out by chi-square analysis test and unconditional multiple Logistic regression analysis test.RESULTS All patients completed bone transport after surgery,the postoperative use time of external fixator was 220 d,the skin naturally healed during bone transport.During treatment,there were 12 cases of bone nonunion in 20 patients,accounting for 60.00%.There were 8 cases of soft tissue incarceration,accounting for 40.00%.There were 5 cases of poor alignment of the broken ends,accounting for 25.00%.Single factor analysis showed that the soft tissue condition was the influence factor of nonunion(χ~2=4.592,P=0.032)and soft tissue incarceration(χ~2=4.201,P=0.040).Non-conditional multiple logistic regression analysis showed that poor soft tissue conditions caused stump nonunion(OR=15.000,95%CI:1.652-136.172,P=0.016),soft tissue incarceration(OR=9.800,95%CI:0.889-106.845,P=0.040).CONCLUSIONS The tibia bone defect patients with transport may have the nonunion of the broken ends,soft tissue incarceration and poor alignment,which may be affected by factors such as soft tissue conditions.The orthopedic surgeon should pay attention to the patients with poor soft tissue conditions during treatment.
作者
申大幸
王珺琛
李帅志
秦大山
SHEN Da-xing;WANG Jun-chen;LI Shuai-zhi;QIN Da-shan(Department of Traumatology and Orthopaedics,General Hospital of China Pingmei Shenma Medical Group,Pingdingshan467000,P.R.China)
出处
《社区医学杂志》
2020年第16期1125-1128,共4页
Journal Of Community Medicine
关键词
胫骨骨缺损
骨搬运手术
软组织嵌顿
断端不愈合
tibial bone defect
bone transfer surgery
soft tissue incarceration
stump non-union
