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首页> 外文期刊>BMC Musculoskeletal Disorders >Reconstruction of massive tibial bone and soft tissue defects by trifocal bone transport combined with soft tissue distraction: experience from 31 cases
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Reconstruction of massive tibial bone and soft tissue defects by trifocal bone transport combined with soft tissue distraction: experience from 31 cases

机译：三焦点骨传输与软组织牵引结合的重建大规模胫骨骨和软组织缺陷：31例经验

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Abstract Background Large post-traumatic tibial bone defects combined with soft tissue defects are a common orthopedic clinical problem associated with poor outcomes when treated using traditional surgical methods. The study was designed to investigate the safety and efficacy of trifocal bone transport (TFT) and soft-tissue transport with the Ilizarov technique for large posttraumatic tibial bone and soft tissue defects. Methods We retrospectively reviewed 31 patients with massive posttraumatic tibial bone and soft tissue defects from May 2009 to May 2016. All of the eligible patients were managed by TFT and soft-tissue transport. The median age was 33.4?years (range, 2–58?years). The mean defect of bone was 11.87?cm ± 2.78?cm (range, 8.2–18.2?cm) after radical resection performed by TFT. The soft tissue defects ranged from 7?cm?×?8?cm to 24?cm?×?12?cm. The observed results included bone union time, wound close time and true complications. The Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system was used to assess bone and functional results and postoperative complications were evaluated by Paley classification. Results The mean duration of follow-up after frame removal was 32?months (range, 12–96?months). All cases achieved complete union in both the elongation sites and the docking sites, and eradication of infection. The mean bone transport time was 94.04 ± 23.33?days (range, 63.7–147?days). The mean external fixation time was 22.74 ± 6.82?months (range, 14–37?months), and the mean external fixation index (EFI) was 1.91 ± 0.3?months/cm (range, 1.2–2.5?months/cm). The bone results were excellent in 6 patients, good in 14 patients, fair in 8 patients and poor in 3 patients. The functional results were excellent in 8 patients, good in 15 patients, fair in 5 patients and poor in 3 patients. Conclusion: TFT, in conjunction with soft tissue transport technique, can give good results in most patients (in this article, good and excellent results were observed in 64% of patients). Soft tissue transport is a feasible method in providing good soft tissue coverage on the bone ends. Although it has no advantages over microvascular techniques, it might be an good alternative in the absence of an experienced flap surgeon. Nonetheless, high-quality controlled studies are needed to assess its long-term safety and efficacy.
机译：摘要背景与软组织缺陷相结合的大型创伤后胫骨骨缺损是在使用传统外科手术方法处理时与差的术语临床问题相关。该研究旨在探讨Trifocal骨转运（TFT）和软组织运输的安全性和功效与ilizarov技术进行大型胫骨胫骨和软组织缺陷。方法我们回顾性地审查了31例患有2009年5月至2016年5月5月至5月5月5日患有巨大胫骨胫骨和软组织缺陷患者的患者。所有合格的患者由TFT和软组织运输管理。中位年龄为33.4岁？年（范围，2-58岁）。在TFT进行的自由基切除后，骨的平均缺陷是11.87Ω±cm±2.78？cm（范围，8.2-18.2厘米）。软组织缺陷范围为7Ω·×8Ω厘米至24Ω·×12？12？厘米。观察结果包括骨联合时间，伤口关闭时间和真实并发症。 ILIZAROV（ASAMI）评分系统方法的研究和应用协会用于评估骨骼和功能性结果，并通过PATEY分类评估术后并发症。结果后续的帧中取出后的平均时间为32？个月（范围，12-96？个月）。所有病例在伸长的网站都和停放地点，并根除感染达到完全结合。平均骨传输时间为94.04±23.33？天（范围，63.7-147？天）。平均外固定时间为22.74±6.82？月（范围，14-37个月），平均外固定指数（EFI）为1.91±0.3？月/厘米（范围，1.2-2.5？月/厘米）。骨结果6例，良14个例，公正8例，差3个例。功能结果8例，良15个例，公平的5例，差3个例。结论：TFT与软组织输送技术相结合，可以在大多数患者中给出良好的结果（在本文中，64％的患者观察到良好和优异的结果）。软组织运输是一种在骨骼端提供良好的软组织覆盖方面可行的方法。虽然它没有针对微血管技术的优势，但在没有经验丰富的襟翼外科医生的情况下可能是一个很好的替代方案。尽管如此，需要高质量的受控研究来评估其长期安全性和疗效。

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