Đánh giá kết quả điều trị khớp giả thân xương dài chi dưới=Evaluation of the treatment outcomes for pseudarthrosis of long bones in the lower limbs

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Trung Hiếu Cao, Mẫn Trường Phú Hồ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.120-124

Bộ sưu tập: Metadata

ID: 477975

Thêm vào giỏ

Điều trị khớp giả xương dài chi dưới cần tuân thủ hai nguyên tắc cơ bản: cố định xương vững chắc và kích thích quá trình liền xương. Việc lựa chọn phương tiện kết hợp xương trong điều trị khớp giả vẫn đang là chủ đề được thảo luận. Phương pháp: Nghiên cứu được thực hiện theo mô hình tiến cứu với 31 bệnh nhân đã được phẫu thuật điều trị khớp giả thân xương dài chi dưới tại Bệnh viện Trung Ương Huế từ tháng 1/2023 đến tháng 7/2024. Kết quả: Độ tuổi trung bình: 34,6 ± 10,5 tuổi. Thời gian theo dõi trung bình: 9 ± 5,8 tháng. Đặc điểm về phương pháp KHX trước phẫu thuật: Nẹp vít: 38,7%, đinh nội tuỷ 61,3%. Tần suất gặp khớp giả: xương đùi 64,5 %, xương chày 35,5%. Vị trí khớp giả: 1/3 trên và 1/3 dưới chiếm 83,9%, 1/3 giữa chiếm 16,1%. Phân độ trên X quang theo Lieberman: độ I 77,4%, độ II 22,6%. Phương pháp phẫu thuật: Nẹp vít: 80,6 %, định nội tuỷ 19,4%. Kết quả sau 3 tháng: 41,9% đạt độ II, 41,9% đạt độ III. Kết quả sau 6 tháng: 80,6% bệnh nhân đạt độ III – IV theo phân độ trên X quang. Kết luận: Phương pháp kết hợp xương bằng nẹp vít hoặc đinh nội tủy kết hợp với ghép xương mang lại hiệu quả cao trong điều trị khớp giả thân xương dài chi dưới.The treatment of nonUNI0N in long bones of the lower limbs must adhere to two basic principles: stable bone fixation and stimulation of bone healing. The choice of fixation methods in treating nonUNI0N remains a subject of discussion. Methods: A prospective study was conducted on 31 patients who underwent surgery for nonUNI0N of long bones in the lower limbs at Hue Central Hospital from January 2023 to July 2024. Results: The average patient age was 34.6 ± 10.5 years, with a mean follow-up duration of 9 ± 5.8 months. Preoperative fixation methods included plates and screws (38.7%) and intramedullary nails (61.3%). NonUNI0N occurred in 64.5% of femur cases and 35.5% of tibia cases. NonUNI0N was located in the upper and lower thirds in 83.9% of cases and in the middle third in 16.1%. According to Lieberman’s classification on Xrays, 77.4% were grade I and 22.6% were grade II. Surgical methods included plates and screws (80.6%) and intramedullary nails (19.4%). After 3 months, 41.9% of patients achieved grade II and 41.9% achieved grade III healing. After 6 months, 80.6% of patients reached grade III-IV according to the X-ray classification. Conclusion: Bone fixation using plates and screws or intramedullary nails combined with bone grafting is highly effective in treating nonUNI0N of long bones in the lower limbs.

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