A MULTI-CENTER STUDY OF THE TREATMENT OF NON-UNION WITH CONSTANT DIRECT-CURRENT
A MULTI-CENTER STUDY OF THE TREATMENT OF NON-UNION WITH CONSTANT DIRECT-CURRENT
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DOI：
10.2106/00004623-198163010-00002
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发表时间：
1981-01-01
影响因子：
5.3
通讯作者：
CONNOLLY, JF
中科院分区：
文献类型：
--
作者：
BRIGHTON, CT;BLACK, J;CONNOLLY, JF
1970年，宾夕法尼亚大学[美国宾夕法尼亚州费城]开展了一项临床研究，以评估恒定直流电在治疗获得性骨不连中的使用。1977年，这项研究扩大到美国各地的12名参与研究人员。结果表明，在适当的电参数和石膏固定的情况下，骨愈合的比率可与植骨手术相媲美。经验表明，需要4个阴极，每个阴极提供20µA的恒定直流电流12wk，以治愈长骨的骨不连。在宾夕法尼亚大学系列治疗的175名患者的178名骨不连患者中，149名(83.7%)获得了坚固的骨愈合。有骨髓炎病史的患者治愈率为74.4%。预先插入的金属固定装置的存在不会影响最终的愈合率。在参与研究人员系列的79名患者的80例骨不连患者中，58例(72.5%)实现了坚固的骨愈合。对直流电治疗失败的骨不连的回顾表明，电力不足、滑膜假关节或感染的存在以及电极的移位是失败的原因。电疗的并发症很小，在没有骨髓炎病史的患者中，电疗没有引起深部感染。使用恒定直流电治疗骨不连的骨科执业医生，通过坚持适当的骨折处理和遵循这些生物物理原理，应该能够达到与植骨手术相当的愈合率，同时相关风险更低。
A clinical study was initiated at the University of Pennsylvania [Philadelphia, Pennsylvania, USA] in 1970 to evaluate the use of constant direct current in treating acquired non-union. In 1977 the study was expanded to include 12 participating investigators throughout the USA. Results indicate that, given proper electrical parameters and proper cast immobilization, a rate of bone union comparable to that seen with bone graft surgery was achieved. Experience dictated that 4 cathodes, each delivering 20 .mu.A of constant direct current for 12 wk, were required to heal a non-union of a long bone. Of 178 non-unions in 175 patients treated with adequate electricity in the University of Pennsylvania series, 149 (83.7%) achieved solid bone union. Patients with a history of osteomyelitis had a healing rate of 74.4%. The presence of previously inserted metallic fixation devices did not affect the end-result healing rate. Of 80 non-unions in 79 patients treated with electricity in the participating investigators'' series, 58 (72.5%) achieved solid bone union. Review of the non-unions treated unsuccessfully with constant direct current suggested that inadequate electricity, the presence of synovial pseudarthrosis or infection, and dislodgment of the electrodes are causes for failure with the procedure. Complications of the electrical treatment were minor and there was no deep infection resulting from this procedure in patients without previous osteomyelitis. The practicing orthopedic surgeon utilizing constant direct current to treat non-union should, by adhering to proper fracture management and by following these biophysical principles, be able to achieve a rate of union comparable to that of bone graft surgery, with a lower associated risk.