التغيرات الشعاعية الحاصلة في الطعوم العظمية المستخدمة في علاج المفاصل الموهمة في العظام الأنبوبية الطويلة
Abstract
شملت الدراسة (38 )حالة مفصل موهم عند 37) ( مريض في العظام الأنبوبية الطويلة قبلوا في مشفى الأسد الجامعي باللاذقية بين عامي (2005-2010) و خضعوا لعملية طعم عظمي للمفصل الموهم
توزع هؤلاء المرضى بين ذكور بنسبة 95%) ( و إناث بنسبة 5%) (و لوحظ أن هذه المفاصل الموهمة تكون أكثر شيوعا بين الأعمار الشابة (20-40) و ذلك بنسبة 59.45%) (وكانت المفاصل الموهمة ضمورية بنسبة 68.5%) ( و ضخامية بنسبة ) 31.5% ( وكانت الكسور المفتوحة موجودة عند ) 23.68% ( أما الإنتان فلوحظ عند ) 34% (
و قد استخدم في علاج هذه المفاصل الطعوم العظمية الذاتية, و تمت مراقبة تطور هذه الطعوم باستخدام الأشعة البسيطة بعد )15يوم,1,6,3,12, شهر( و قد لاحظنا أن مراحل الاندمال الطبيعي للطعم تتلخص في ثلاث مراحل من الناحية الشعاعية
المرحلة الأولى :مشاهدة منطقة شفوفية (ناقصة الكثافة) بين الطعم و حواف العظم (المُطعَّم) مع علامات تخلل عظمي في الحواف
المرحلة الثانية :تراجع في مساحة منطقة الشفوفية الفاصلة بين الطعم و العظم و نقص وضوحية الحواف
المرحلة الثالثة :تشكل عظمي جديد مع علامات اندمال الطعم و غياب تام لخط الكسر
This study includes 38 pseudoarthrosis in long bones in 37 patients admitted to the Department of Surgery in Al-ASSAD University Hospital in Lattakia, over the period spanning 2005-2010, and have been subject to procedures over pseudarthrosis.
The distribution was (95%) male and (5%) female. We have noted that this problem is common in young ages (20-40 years). Atrophic pseudoarthrosis were (68.5%) and hypertrophic (31.5%). Patients suffered from open fractures in (23.68%) and infection was in (34%).
The autografts were used in treatment of these pseudoarthrosis. We monitored the development of grafting by x-rays after (15 days,1,3,6,12 months) post surgery. We noted that stages of nature healing of bone graft were classified as three radiological stages [9]:
Stage 1: Radiolucent zone between bone cavity and the graft
Stage 2: Decrease of radiolucent zone and hazy margins
Stage 3: Bone formation and integration of graft signs
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