{"title":"优化骨运输策略：双焦点和三焦点技术中基于像素值比率的再生率评估。","authors":"Xin Yang, Yimurang Hamiti, Kai Liu, Sulong Wang, Xiriaili Kadier, Debin Xiong, Aihemaitijiang Yusufu","doi":"10.3389/fsurg.2024.1494658","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Bone transport techniques are crucial for managing large bone defects, but the optimal approach for different defect lengths remains unclear. This study aimed to compare bone regeneration rates between short bifocal bone transport (SBBT), long bifocal bone transport (LBBT), and trifocal bone transport (TBT) using pixel value ratio (PVR) as an objective quantitative measure.</p><p><strong>Methods: </strong>This retrospective study included 60 patients undergoing lower limb bone transport, divided into SBBT (<i>n</i> = 22, defects <6 cm), LBBT (<i>n</i> = 20, defects ≥6 cm), and TBT (<i>n</i> = 18, defects ≥6 cm) groups. PVR was measured at 4, 8, and 12 weeks postoperatively using standardized digital radiographs. Healing index (HI) and external fixation index (EFI) were calculated to assess treatment efficiency. Demographic data, surgical characteristics, and complications were also analyzed.</p><p><strong>Results: </strong>TBT showed significantly higher PVR values compared to LBBT at all time points (4 weeks: 0.779 ± 0.036 vs. 0.719 ± 0.027, <i>p</i> < 0.001; 8 weeks: 0.822 ± 0.027 vs. 0.787 ± 0.025, <i>p</i> = 0.008; 12 weeks: 0.866 ± 0.024 vs. 0.835 ± 0.016, <i>p</i> = 0.023) and to SBBT at 4 and 8 weeks (<i>p</i> < 0.001 and <i>p</i> = 0.016, respectively). The TBT group demonstrated significantly lower HI and EFI compared to both SBBT and LBBT groups (<i>p</i> < 0.05), indicating faster healing and shorter treatment times. Although SBBT showed slightly higher PVR values than LBBT, the differences were not statistically significant.</p><p><strong>Conclusion: </strong>Trifocal bone transport leads to faster bone regeneration and shorter treatment times compared to bifocal techniques, particularly for longer bone defects. The study demonstrates that defect length alone may not be the primary factor influencing regeneration rates in bifocal transport. PVR proves to be a reliable and cost-effective tool for assessing bone regeneration in different bone transport techniques, offering potential for guiding clinical decision-making. These findings suggest that trifocal transport should be considered as a preferred method for treating larger bone defects, especially when minimizing treatment time is crucial.</p>","PeriodicalId":12564,"journal":{"name":"Frontiers in Surgery","volume":"11 ","pages":"1494658"},"PeriodicalIF":1.6000,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666508/pdf/","citationCount":"0","resultStr":"{\"title\":\"Optimizing bone transport strategies: a pixel value ratio-based evaluation of regeneration rates in bifocal and trifocal techniques.\",\"authors\":\"Xin Yang, Yimurang Hamiti, Kai Liu, Sulong Wang, Xiriaili Kadier, Debin Xiong, Aihemaitijiang Yusufu\",\"doi\":\"10.3389/fsurg.2024.1494658\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Bone transport techniques are crucial for managing large bone defects, but the optimal approach for different defect lengths remains unclear. This study aimed to compare bone regeneration rates between short bifocal bone transport (SBBT), long bifocal bone transport (LBBT), and trifocal bone transport (TBT) using pixel value ratio (PVR) as an objective quantitative measure.</p><p><strong>Methods: </strong>This retrospective study included 60 patients undergoing lower limb bone transport, divided into SBBT (<i>n</i> = 22, defects <6 cm), LBBT (<i>n</i> = 20, defects ≥6 cm), and TBT (<i>n</i> = 18, defects ≥6 cm) groups. PVR was measured at 4, 8, and 12 weeks postoperatively using standardized digital radiographs. Healing index (HI) and external fixation index (EFI) were calculated to assess treatment efficiency. Demographic data, surgical characteristics, and complications were also analyzed.</p><p><strong>Results: </strong>TBT showed significantly higher PVR values compared to LBBT at all time points (4 weeks: 0.779 ± 0.036 vs. 0.719 ± 0.027, <i>p</i> < 0.001; 8 weeks: 0.822 ± 0.027 vs. 0.787 ± 0.025, <i>p</i> = 0.008; 12 weeks: 0.866 ± 0.024 vs. 0.835 ± 0.016, <i>p</i> = 0.023) and to SBBT at 4 and 8 weeks (<i>p</i> < 0.001 and <i>p</i> = 0.016, respectively). The TBT group demonstrated significantly lower HI and EFI compared to both SBBT and LBBT groups (<i>p</i> < 0.05), indicating faster healing and shorter treatment times. Although SBBT showed slightly higher PVR values than LBBT, the differences were not statistically significant.</p><p><strong>Conclusion: </strong>Trifocal bone transport leads to faster bone regeneration and shorter treatment times compared to bifocal techniques, particularly for longer bone defects. The study demonstrates that defect length alone may not be the primary factor influencing regeneration rates in bifocal transport. PVR proves to be a reliable and cost-effective tool for assessing bone regeneration in different bone transport techniques, offering potential for guiding clinical decision-making. These findings suggest that trifocal transport should be considered as a preferred method for treating larger bone defects, especially when minimizing treatment time is crucial.</p>\",\"PeriodicalId\":12564,\"journal\":{\"name\":\"Frontiers in Surgery\",\"volume\":\"11 \",\"pages\":\"1494658\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-12-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666508/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fsurg.2024.1494658\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fsurg.2024.1494658","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景：骨运输技术是处理大型骨缺损的关键，但不同长度的缺损的最佳方法尚不清楚。本研究旨在比较短双焦点骨运输（SBBT）、长双焦点骨运输（LBBT）和三焦点骨运输（TBT）之间的骨再生率，采用像素值比（PVR）作为客观的定量指标。方法：回顾性研究60例下肢骨移植患者，分为SBBT组（22例，缺损20例，缺损≥6 cm）和TBT组（18例，缺损≥6 cm）。术后4周、8周和12周采用标准化数字x线片测量PVR。计算愈合指数（HI）和外固定指数（EFI）评估治疗效果。并分析了人口统计学资料、手术特点和并发症。结果：TBT在所有时间点的PVR值均显著高于LBBT(4周：0.779±0.036 vs 0.719±0.027,p p = 0.008；12周：0.866±0.024 vs. 0.835±0.016,p = 0.023)和4周和8周时的SBBT （p = 0.016）。与SBBT和LBBT组相比，TBT组的HI和EFI明显较低(p结论：与双焦点技术相比，三焦点骨运输导致更快的骨再生和更短的治疗时间，特别是对于较长的骨缺损。研究表明，缺陷长度本身可能不是影响双焦点移植再生率的主要因素。PVR被证明是评估不同骨运输技术中骨再生的可靠且具有成本效益的工具，为指导临床决策提供了潜力。这些发现表明，对于治疗较大的骨缺损，尤其是在缩短治疗时间至关重要的情况下，应考虑将三焦转移作为首选方法。
Optimizing bone transport strategies: a pixel value ratio-based evaluation of regeneration rates in bifocal and trifocal techniques.
Background: Bone transport techniques are crucial for managing large bone defects, but the optimal approach for different defect lengths remains unclear. This study aimed to compare bone regeneration rates between short bifocal bone transport (SBBT), long bifocal bone transport (LBBT), and trifocal bone transport (TBT) using pixel value ratio (PVR) as an objective quantitative measure.
Methods: This retrospective study included 60 patients undergoing lower limb bone transport, divided into SBBT (n = 22, defects <6 cm), LBBT (n = 20, defects ≥6 cm), and TBT (n = 18, defects ≥6 cm) groups. PVR was measured at 4, 8, and 12 weeks postoperatively using standardized digital radiographs. Healing index (HI) and external fixation index (EFI) were calculated to assess treatment efficiency. Demographic data, surgical characteristics, and complications were also analyzed.
Results: TBT showed significantly higher PVR values compared to LBBT at all time points (4 weeks: 0.779 ± 0.036 vs. 0.719 ± 0.027, p < 0.001; 8 weeks: 0.822 ± 0.027 vs. 0.787 ± 0.025, p = 0.008; 12 weeks: 0.866 ± 0.024 vs. 0.835 ± 0.016, p = 0.023) and to SBBT at 4 and 8 weeks (p < 0.001 and p = 0.016, respectively). The TBT group demonstrated significantly lower HI and EFI compared to both SBBT and LBBT groups (p < 0.05), indicating faster healing and shorter treatment times. Although SBBT showed slightly higher PVR values than LBBT, the differences were not statistically significant.
Conclusion: Trifocal bone transport leads to faster bone regeneration and shorter treatment times compared to bifocal techniques, particularly for longer bone defects. The study demonstrates that defect length alone may not be the primary factor influencing regeneration rates in bifocal transport. PVR proves to be a reliable and cost-effective tool for assessing bone regeneration in different bone transport techniques, offering potential for guiding clinical decision-making. These findings suggest that trifocal transport should be considered as a preferred method for treating larger bone defects, especially when minimizing treatment time is crucial.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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