Ⅰ期病灶清除灌注冲洗,Ⅱ期腓骨瓣游离移植在股骨慢性骨髓炎中的应用  

Application of phase Ⅰ focus clearance, flushing and phase Ⅱ fibular flap free grafting in the treat-ment of chronic femoral osteomyelitis

作　　者：杜晓龙 宋涛[1] 欧学海 刘亚飞 张文韬 从飞 刘晓敏 Du Xiaolong;Song Tao;Oue Xuehai(Department of Orthopaedics, Microsurgical Repair of Bone, the Affiliated Honghui Hospital of Xi'an Jiaotong University, Xi'an 710054, China)

机构地区：[1]西安交通大学附属红会医院骨显微修复外科,710054

出　　处：《美中国际创伤杂志》2019年第1期25-27,52,共4页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨股骨慢性骨髓炎术后骨缺损的治疗方案,明确腓骨瓣在治疗股骨骨髓炎后骨缺损植骨中应用的疗效。方法:回顾性分析2014年1月至2016年6月在我科就诊的股骨骨髓炎行Ⅰ期病灶清除灌注冲洗,Ⅱ期腓骨瓣游离移植治疗的患者,共收集到资料14例。其中男性11例,女性3例,年龄25-61岁,平均40.4岁。对所有患者进行随访,回顾伤口有无感染,记录血沉、C反应蛋白、白细胞数目,术后1月、3月、6月及 1年复查X线片,观察骨质有无愈合。结果:所有患者均得到随访,随访时间6-18个月,平均12个月。所有患者术后未出现伤口红肿、伤口裂开等急性感染表现,但1例患者术后2w时伤口有少量渗出,后伤口形成窦道,所有患者白细胞数量较术前均有升高,但术后2w均将至正常,血沉、CRP均升高。11例患者术后6月时可见骨痂形成,术后1年时所有患者均可见骨质连接。结论:腓骨皮瓣可以改善骨髓炎患者局部血运,并提供活骨与骨缺损区,是治疗骨髓炎术后骨缺损的有效方式。Objective: To investigate the therapeutic effect of fibular flap in the treatment of chronic femoral osteomyelitis. Methods: A total of 14 patients with femoral osteomyelitis, including 11 male and 3 female, aging between 25 and 61 years (mean 40.4 years), undenvent phase Ⅰ focus clearance, flushing and phase Ⅱ fibular flap free grafting from January 2014 to June 2016. The data (wound cond让ion, blood sedimentation rate, C reactive protein, leucocyte count and X-ray films) of all cases were analyzed retrospectively. Results: All patients were followed-up for 6-18 months, with an average time of 12 months. There was a little exudation on the wound and form to a sinus in 1 case. Leucocyte count increased postoperatively and decreased to normal 2 weeks after surgery. Erythrocyte sedimentation rate and CRP both were elevated. Callus formation observed 6 months after operation in 11 cases and bone connection noted 1 year after surgery. Conclusion: The fibular flap for treatment of the patients with bone defect after chronic femoral osteomyelitis is an effective method because which can improve the local blood supply of osteomyelitis.

关 键 词：腓骨瓣 慢性骨髓炎 骨缺损 显微手术 

分 类 号：R681.2[医药卫生—骨科学]