E. Shchepkina, N. L. Solomin, K. L. Korchagin, F. Sabirov
{"title":"甲上骨运输与Ilizarov法治疗创伤后股骨和胫骨缺损的比较","authors":"E. Shchepkina, N. L. Solomin, K. L. Korchagin, F. Sabirov","doi":"10.25016/2541-7487-2021-0-2-80-88","DOIUrl":null,"url":null,"abstract":"Relevance. From the point of view of using the advantages of both external fixation and internal osteosynthesis, the method “Bone transport over the nail” (BTON) deserves attention.Intention: To compare the effectiveness of the BTON and Ilizarov method in the treatment of patients with post-traumatic defects of the long bones of the lower extremities.Methodology. We analyzed 24 BTON cases and 47 cases of defects replacement via the Ilizarov method. The analysis included patients with segmental defects of the tibia, femur and knee joint bone defects complicated by chronic osteomyelitis.Results and Discussion. The external fixation period in BTON group was 3 times less than in the comparison group, as was the external fixation index. In case of monolocal defect replacement, the external fixation period and external fixation index in the BTON group was 4 times less than in the Ilizarov defect replacement group. With bifocal replacement of the defect, the external fixation period was 2.5 times less, and the external fixation index was 2 times less. BTON interventions were associated with complications in 31 cases (129.2 %) vs 82 cases for the Ilizarov method (174.5 %). The most pronounced decrease (3 times) was noted for cases of transosseous elements inflammation.Conclusion. The “Bone transport over the nail” technique reduces the external fixation period by an average of 3 times. This facilitates management of the outpatient phase and reduces the number of complications, especially the pin-tract infection. Cable technique combined with an orthopedic hexapod allows bifocal replacement of extended defects of the distal femur and knee joint applying the apparatus only to the lower leg. Risks of jamming the transported bone fragments by the intramedullary nail are thus excluded. To avoid breaking the traction cable, only designated devices should be used.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"11 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Bone transport over the nail vs Ilizarov method in the treatment of posttraumatic defects of the femur and tibia\",\"authors\":\"E. Shchepkina, N. L. Solomin, K. L. Korchagin, F. Sabirov\",\"doi\":\"10.25016/2541-7487-2021-0-2-80-88\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Relevance. From the point of view of using the advantages of both external fixation and internal osteosynthesis, the method “Bone transport over the nail” (BTON) deserves attention.Intention: To compare the effectiveness of the BTON and Ilizarov method in the treatment of patients with post-traumatic defects of the long bones of the lower extremities.Methodology. We analyzed 24 BTON cases and 47 cases of defects replacement via the Ilizarov method. The analysis included patients with segmental defects of the tibia, femur and knee joint bone defects complicated by chronic osteomyelitis.Results and Discussion. The external fixation period in BTON group was 3 times less than in the comparison group, as was the external fixation index. In case of monolocal defect replacement, the external fixation period and external fixation index in the BTON group was 4 times less than in the Ilizarov defect replacement group. With bifocal replacement of the defect, the external fixation period was 2.5 times less, and the external fixation index was 2 times less. BTON interventions were associated with complications in 31 cases (129.2 %) vs 82 cases for the Ilizarov method (174.5 %). The most pronounced decrease (3 times) was noted for cases of transosseous elements inflammation.Conclusion. The “Bone transport over the nail” technique reduces the external fixation period by an average of 3 times. This facilitates management of the outpatient phase and reduces the number of complications, especially the pin-tract infection. Cable technique combined with an orthopedic hexapod allows bifocal replacement of extended defects of the distal femur and knee joint applying the apparatus only to the lower leg. Risks of jamming the transported bone fragments by the intramedullary nail are thus excluded. To avoid breaking the traction cable, only designated devices should be used.\",\"PeriodicalId\":36526,\"journal\":{\"name\":\"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations\",\"volume\":\"11 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-06-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.25016/2541-7487-2021-0-2-80-88\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Health Professions\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.25016/2541-7487-2021-0-2-80-88","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Health Professions","Score":null,"Total":0}
引用次数: 0
摘要
的相关性。从利用外固定和内固定的优点来看,“甲上骨运输”(Bone transport over the nail, BTON)方法值得关注。目的:比较BTON与Ilizarov法治疗创伤后下肢长骨缺损的疗效。我们分析了24例BTON和47例Ilizarov法缺损置换。分析包括胫骨、股骨和膝关节骨缺损合并慢性骨髓炎的患者。结果和讨论。BTON组外固定时间比对照组短3倍,外固定指标比对照组短3倍。在单局部缺损置换术中,BTON组外固定时间和外固定指数比Ilizarov缺损置换术组短4倍。双焦点置换缺损后,外固定时间缩短2.5倍,外固定指数减少2倍。BTON干预有31例(129.2%)与Ilizarov方法的82例(174.5%)相关。经骨因子炎症的发生率明显下降,为3倍。“经甲骨转运”技术可将外固定时间平均缩短3倍。这有利于门诊阶段的管理,减少并发症的数量,特别是针道感染。电缆技术与矫形六足架相结合,允许双焦点替代股骨远端和膝关节的扩展缺陷,只需将器械应用于小腿。因此排除了髓内钉堵塞运送骨碎片的风险。为避免拉断牵引电缆,只能使用指定的装置。
Bone transport over the nail vs Ilizarov method in the treatment of posttraumatic defects of the femur and tibia
Relevance. From the point of view of using the advantages of both external fixation and internal osteosynthesis, the method “Bone transport over the nail” (BTON) deserves attention.Intention: To compare the effectiveness of the BTON and Ilizarov method in the treatment of patients with post-traumatic defects of the long bones of the lower extremities.Methodology. We analyzed 24 BTON cases and 47 cases of defects replacement via the Ilizarov method. The analysis included patients with segmental defects of the tibia, femur and knee joint bone defects complicated by chronic osteomyelitis.Results and Discussion. The external fixation period in BTON group was 3 times less than in the comparison group, as was the external fixation index. In case of monolocal defect replacement, the external fixation period and external fixation index in the BTON group was 4 times less than in the Ilizarov defect replacement group. With bifocal replacement of the defect, the external fixation period was 2.5 times less, and the external fixation index was 2 times less. BTON interventions were associated with complications in 31 cases (129.2 %) vs 82 cases for the Ilizarov method (174.5 %). The most pronounced decrease (3 times) was noted for cases of transosseous elements inflammation.Conclusion. The “Bone transport over the nail” technique reduces the external fixation period by an average of 3 times. This facilitates management of the outpatient phase and reduces the number of complications, especially the pin-tract infection. Cable technique combined with an orthopedic hexapod allows bifocal replacement of extended defects of the distal femur and knee joint applying the apparatus only to the lower leg. Risks of jamming the transported bone fragments by the intramedullary nail are thus excluded. To avoid breaking the traction cable, only designated devices should be used.