Orthofix外固定支架骨移植技术治疗胫骨感染性骨不连疗效分析  

Treatment of tibial infected nonunion using Ilizarov bone transport and Orthofix external fixator

作　　者：曾剑文[1] 谢建军[1] 吴渊[1] 付剑平[1] 

机构地区：[1]武警江西总队医院骨科,南昌330030

出　　处：《武警医学》2017年第1期13-15,18,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨Orthofix外固定支架骨移植技术治疗胫骨感染性不愈合的疗效。方法回顾性分析2010-01至2014-12治疗的20例胫骨感染性不愈合患者资料,男16例,女4例;年龄19~56岁,平均(36.2±18.2)岁;首先进行感染骨段切除、抗生素硫酸钙骨粉植入,然后行Orthofix外固定支架骨移植技术治疗骨缺损,末次随访时采用Paley骨与功能评分方法及患者满意度评定疗效。结果所有患者术后获12~30个月[平均(20.6±8.3)个月]随访:20例患者骨缺损全部获愈合,其中12例一期愈合;3例骨移植到位后对接端出现骨不连,植骨后愈合。5例去除外固定更换内固定植骨断端新鲜化后愈合。末次随访时Paley骨折愈合评分结果:优16例,良2例,可2例,优良率为90%;Paley功能评分结果:优14例,良3例,可3例,优良率为85%;患者满意度:非常满意14例,满意3例,一般3例,满意率为85%。本组12例发生钉道感染,1例出现踝关节僵硬,1例出现膝关节僵硬。结论应用Orthofix外固定支架骨移植技术可以有效修复胫骨感染性骨不连。Objective To investigate the effect of treatment of tibial infected nonunion using Ilizarov bone transport and Orthofix external fixator. Methods Clinical data on twenty patients（ sixteen males and four males,aged 19 to 56 years） with tibia I irifected nonunion treated in our department between January 2010 and December 2014 were retrospectively analyzed. They were treated first with excision of the infected bone segment and implantation of calcium sulfate,followed by Ilizarov bone transport to repair the bone defect. The clinical efficacy was assessed using the Paley evaluation system and the patients＇ level of satisfaction during the last followups. Results The patients were followed up for 12 to 30 months（ average,20. 6 months）. Bone defects were repaired in allthe patients. Primary bone healing was achieved in 12 cases while bone grafting had to be performed in the other 3 cases to repair bone union after bone transport. 5 cases were healed with bone grafting,fresh of fracture broken ends,replacement of internal fixation after removal of external fixation. According to the Pales＇ s system,the bone union was excellent in 16 cases,good in 2,dnd fair in 2 cases,with a good-toexcellent rate of 90%. The functional outcome was excellent in 14 cases,good in 3,and fair in 3 cases,with a good-to-excellent rate of85%. 14 patients felt quite satisfie. 3 satisfied and 3 somewhat dissatisfied with the functional outcomes. Pin tract infection occurred in12 cases,ankle joint stiffness in 1,and limited knee joint stiffness in 1 case. Conclusions The application of Orthofix external fixation technology can effectively repair tibia bone infected nonunion.

关 键 词：骨感染 Orthofix外固定架 

分 类 号：R683.42[医药卫生—骨科学]