摘要
目的探讨应用IIizarov外固定架骨搬运技术治疗胫骨骨折术后感染、骨缺损临床疗效。方法对60例胫骨骨折术后感染、骨缺损患者依据Ilizarov技术标准进行治疗。术后定期摄X线片复查,评估牵张成骨情况。结果 60例均获得随访,时间18~30个月。骨搬运完成时间2~7个月,骨搬运长度6~18 cm。患者未出现血管神经损伤等并发症。6例出现钉道反应,1例切口皮缘水肿,均经治疗后愈合;17例搬运后期出现对线不良,经调整骨搬运方向、少量植骨,均获对位对线骨性愈合。骨搬运完成后9个月,按Paley et al骨折愈合评分标准评价疗效:优45例,良6例,可8例,差1例。骨缺损断端骨愈合及牵张成骨区成骨愈合满意,软组织创面愈合满意,所有患肢长度恢复良好,与健侧对比无明显差异。结论采用Ilizarov外固定架骨搬运技术进行感染扩创、炎性病变切除、骨段搬运修复骨缺损,对胫骨术后感染的控制、肢体功能的重建具有确切的临床疗效。
Objective To investigate the clinical efficacy of Ilizarov external fixation of tibial bone transport technique.Methods The 60 cases suffered with bone defect and infection of tibia after surgery were treated,according to Ilizarov technique standard,all cases were treated with sensitive antibiotics preoperative and Ilizarov device.The distraction osteogenesis of bone removal were evaluated by the regular X-ray films examination.Results Follow-up time was 18~30 months.Duration of bone transport time was 2~7 months,bone transport length was 6~18 cm.There were not vascular nerve injury and other complications.There were 6 cases of pin tract reaction and 1 case of incision derma edema,all cases healed after treatment.In 17 cases,there was malalignment in the later period of bone transport,after adjusting the direction of bone transport and a little bone grafts,all cases got bone healing.At 9 months after bone tramsport finish,according to Paley et al fracture healing score standard,the results was excellent in 45 cases,good 6,fair 8 and poor 1.The bone healing located in the area of bone defects and distraction osteogenesis was satisfactory.The wound healing was also satisfactory.All patients′limbs length recovered well.No significant difference existed between contralateral comparison.Conclusions Ilizarov technique with external fixation and bone transport has definite clinical effects in controlling tibial postoperative infection and the reconstruction of limb function,through infection debridement,inflammatory lesion resection and bone transporting in repairing bone defect.
作者
辛晓林
张林峰
王顺利
史迎宾
XIN Xiao-lin;ZHANG Lin-feng;WANG Shun-li;SHI Ying-bin(SectionⅠ,Dept of Bone Tumor and Diseases,Orthopaedics Hospital of Zhengzhou City,Zhengzhou,Henan450052,China)
出处
《临床骨科杂志》
2018年第2期193-195,共3页
Journal of Clinical Orthopaedics
