| Objective:To observe the effect of "accordion technique" in the treatment of tibia bone defect,and analyze the clinical effect of "accordion technique".Methods:From May 2017 to October 2019,22 patients with tibia bone defect were treated with Ilizarov bone transfer technique,including 19 males and 3 females ranging from 20 to 60(47.1±11.2)years old.The course of the disease was 8 to 24 months(16.2±3.8).22 patients were randomly divided into the accordion group and the control group by using a random number table method.In the accordion group there are 11 cases,in which 9 cases are male and 2 cases are female,ranging from 20 to 60(41.6+13.3)years old and whose bone defect length ranging from 3 to 13(6.4+2.6)cm.There were 4 cases induced by traffic accidents,4 cases induced by falling down and 3 cases caused by bruise.At the end of the bone transport,accordion operation was implemented to osteogenesis area.In the control group,there were 11 cases,including 10 males and 1 female,ranging from 41 to 60(51.6±6.4)years old and bone defect length ranging from 3.0 to 10.7(6.6±2.5)cm.There were 6 cases caused by traffic accidents,falling down in 2 cases and bruise in 3 cases.Indexes such as Hydroxylapatite(HAP)content,mineralization time and healing time were compared between the two groups before the operation of the accordions,after the operation of the accordions,1 month and 2 months after the operation of the accordions.The therapeutic effect of bone healing was evaluated by Paley score et al.Results:All 22 patients were followed up for 18?36(27.0±6.3)months.All the wounds in the bone defect healed naturally during the bone removal process,without skin infection,skin necrosis and other wound complications.HAP content in osteogenic area of the two groups before the operation of the accordions,after the operation of the accordions,1 month and 2 months after operation of "accordion" was as follows:In the accordion group,they were(3969.731950.65)mg,(6174.08±1706.88)mg,(6924.81±2108.26)mg and(8019.21±3200.60)mg.In the control group,they were(3948.65±1440.02)mg,(4569.2511250.35)mg,(4856.29±1271.46)mg and(5104.86±1197.38)mg.HAP of the newborn callus region in the two groups were compared before accordion operation and the difference was not statistically significant(p>0.05).But HAP of the newborn callus region compared after accordion operation,the difference was statistically significant(p<0.05).In the accordion group,the mineralization time was 321.4±76.2 days and the healing time was 379.9±35.4 days.In the control group,mineralization time was(385.0±85.7)days and healing time was(446.0±40.5)days.Mineralization time and healing time of the two groups were compared,and the difference was statistically significant(p<0.05).Paley's scoring were used to evaluate the results of bone defect treatment:10 cases were excellent,1 case was good,and 0 cases were poor in accordion group.In the control group,there were 9 excellent cases,2 good cases and 0 poor cases.There was no significant difference between the two groups(Z=-0.607,P=0.544).Gonclusion:In the treatment of tibial bone defect by Ilizarov bone transfer technique,the application of "accordion technique" can promote the bone mineralization rate in the distraction osteogenesis zone,and shorten the mineralization time and healing time. |
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