文章摘要
黄晓文,韩 巍,刘亚军,张隆浩,公茂琪,蒋协远.体外冲击波和传统植骨内固定治疗肥大型骨折不愈合的临床研究[J].南京医科大学学报,2015,(10):1432~1436
体外冲击波和传统植骨内固定治疗肥大型骨折不愈合的临床研究
Comparison of the treatment results of hypertrophic nonunion by using extracorporeal shock wave therapy (ESWT) or traditional iliac autograft and internal fixation
投稿时间:2015-01-25  
DOI:10.7655/NYDXBNS20151022
中文关键词: 体外冲击波治疗  骨折不愈合  肥大型
英文关键词: extracorporeal shock wave therapy (ESWT)  nonunion  hypertrophic
基金项目:北京市医管局临床医学发展专项“扬帆计划”项目(XMLX201307)
作者单位
黄晓文 清华大学医学中心,北京 100084 
韩 巍 北京积水潭医院创伤骨科,北京 100035 
刘亚军 北京积水潭医院创伤骨科,北京 100035 
张隆浩 北京积水潭医院创伤骨科,北京 100035 
公茂琪 北京积水潭医院创伤骨科,北京 100035 
蒋协远 北京积水潭医院创伤骨科,北京 100035 
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中文摘要:
      目的:比较运用体外冲击波和传统植骨内固定两种方法治疗肥大型骨折不愈合的临床疗效。方法:设计前瞻性的随机临床对照研究,将符合纳入排除标准且同意参与本临床研究的骨折不愈合患者72例,分为A组(体外冲击波治疗组)和B组(自体髂骨植骨+坚强内固定组),两组患者基线资料无统计学差异(P > 0.05)。A组予以体外冲击波治疗3次,间隔7 d;B组行传统切开复位坚强内固定+自体髂骨植骨。平均随访18.2个月。比较两组骨折愈合率?骨痂出现时间?骨折愈合时间?治疗费用和并发症等情况。结果:两组在愈合率上未及明显统计学差异(P > 0.05),骨痂出现时间上B组较A组早(P < 0.05)。但在最终愈合时间上两组未见明显统计学差异(P > 0.05)。在平均治疗费用上A组较B组明显降低(P < 0.05)。结论:体外冲击波对于肥大型骨折不愈合治疗有着较好的临床疗效和经济效益,建议在行传统植骨内固定手术前应进行体外冲击波治疗。
英文摘要:
      Objective:To explore and compare the results of the treatment of hypertrophic nonunion of limb fractures by using extracorporeal shock wave therapy (ESWT) or traditional iliac autograft and internal fixation. Method: A prospective randomized control study was designed. A total of 72 patients were recruited from June 2012 to June 2013 according to inclusion-exclusion criteria, and randomly divided into two groups. Group A referred to using ESWT with 39 cases for 3 times with interval of 7 days, while 33 cases in Group B treated with traditional iliac autograft and internal fixation. The baseline of the two groups had no significant difference (P > 0.05). Mean follow-up was 18.2 months. The appearance time of callus, the final healing time of fractures, the cost of treatments and postoperative complications were record. Results: No significant difference was found in the final cure rates of the two groups (P > 0.05). Group B presented earlier in the appearance time of callus (P < 0.05), however, the final healing time of fractures showed no significant difference between the two groups (P > 0.05). Group B showed higher cost of treatment(P < 0.05). Conclusion: Treatment of hypertrophic nonunion of fractures by ESWT is safe and effective with advantages of minimal invasive, high cure rate, low expense and less complications. ESWT is suggested to be used for the hypertrophic nonunion patients before traditional iliac autograft and internal fixation.
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