Masquelet技术治疗前臂单骨感染性骨缺损临床疗效分析  

Clinical curative effect analysis of Masquelet technique for treatment of infected single-bone defect of forearm

作　　者：马鑫[1] 周大鹏[1] 刘兵[1] 刘欣伟[1] 孙齐明 张昊[1] MA Xin ZHOU Da-peng LIU Bing LIU Xin-wei SUN Qi-ming ZHANG Hao(Department of Orthopaedics,General Hospital of Shenyang Military, Shenyang Liaoning 110016, China)

机构地区：[1]沈阳军区总医院骨科,全军重症战创伤救治中心,辽宁沈阳110016

出　　处：《局解手术学杂志》2017年第6期410-414,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：全军重大课题(AWS14C003)

摘　　要：目的分析应用Masquelet技术治疗前臂单骨感染性骨缺损的机理及临床疗效。方法回顾性分析2011年1月至2016年6月我科收治的18例前臂单骨感染性骨缺损患者的临床资料。所有病例给予Masquelet技术进行二阶段治疗,第一阶段彻底清创、抗生素PMMA骨水泥填充骨缺损及内固定,第二阶段治疗在一期治疗结束6~8周后,在骨缺损处应用自体髂骨植骨。随访观察18例患者感染控制、骨折愈合及相关并发症情况。结果所有病例均无感染复发、植骨吸收、接骨板螺钉松动断裂等情况发生;按Anderson功能评价体系评价功能恢复:良好9例,满意6例,不满意3例,无失败病例,满意率83.33%。结论应用Masquelet技术植入PMMA骨水泥局部释放持续抗生素来控制感染,通过体内诱导在骨缺损部位产生自体膜结构,然后移植自体松质骨对骨缺损实施重建修复治疗,是治疗前臂单骨感染性骨缺损的有效方法。Objective To evaluate the clinical curative effect of Masquelet technique in treatment of infected single-bone defect of fore- arm. Methods The clinical data of 18 cases of forearm bone defect caused by bone infection in our department from January 2011 to June 2016 were retrospectively analyzed. All the patients received standard treatment of Masquelet technique with two stage. Radical debridement, bone defect filling with antibiotic PMMA bone cement, and internal fixation were accomplished at the first stage, and treatment of bone defect with autologous iliac bone graft were accomplished at the second stage after 6 to 8 weeks at the end of the first stage. The infection control, fracture healing and complications of the 18 patients were observed. Results There was no complications such as infection recurrence, bone resorption, plate screw loosening occured. The functional recovery of 18 cases in this group was evaluated according to the Anderson evaluation scale, The results were excellent in 9 cases, satisfactory in 6 cases, unsatisfactory in 3 cases, and no failure. The satisfactory rate was 83.33 %. Conclusion Controlling infection with local release of antibiotics from PMMA bone cement implantation through Masquelet technique, indu- cing autogenous membrane structure in the bone defect area, and then transplanting autologous cancellous bone for bone defect reconstruction repair treatment are effective in the treatment of infected single-bone defect of forearm.

关 键 词：开放骨折 骨水泥 Masquelet技术 诱导膜 骨缺损 

分 类 号：R681.2[医药卫生—骨科学] R681.8[医药卫生—外科学]