膜诱导技术一期应用不同固定方式治疗胫骨远端创伤后骨髓炎的疗效比较  

Different fixation methods with induced membrane technique in first-stage treatment of distal tibial post-traumatic osteomyelitis

作　　者：李洋 胡适 喻胜鹏 沈杰 谢肇 LI Yang;HU Shi;YU Sheng-peng;SHEN Jie;XIE Zhao(Department of Orthopedics,First Hospital Affiliated to Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院骨科,重庆400038

出　　处：《局解手术学杂志》2021年第1期35-39,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：军队后勤科研课题(AWS173004-02-05)。

摘　　要：目的比较膜诱导技术一期应用锁定钢板内固定与锁定加压钢板外固定治疗胫骨远端创伤后骨髓炎的疗效。方法回顾性分析应用膜诱导技术治疗的39例胫骨远端创伤后骨髓炎患者的临床资料,其中一期应用锁定钢板内固定23例(钢板内置组),应用锁定加压钢板外固定16例(钢板外置组),2组患者二期植骨均应用髓内钉内固定。比较2组患者的感染控制率、骨愈合率、愈合时间和术后美国足踝外科学会(AOFAS)踝关节功能评分等。结果术后随访30~86个月,2组患者术后感染控制率、骨愈合率、愈合时间、AOFAS踝关节功能评分比较,差异均无统计学意义(P>0.05)。结论膜诱导技术一期应用锁定钢板内固定与锁定加压钢板外固定治疗胫骨远端创伤后骨髓炎均可取得比较满意的疗效,一期采用内固定作为稳定方式并不会增加感染的复发率。Objective To compare the effects of locking plate internal fixation and locking compression plate external fixation with induced membrane technique in the first-stage treatment of distal tibial post-traumatic osteomyelitis.Methods The clinical data of 39 patients with distal tibial post-traumatic osteomyelitis treated with induced membrane technique were retrospectively analyzed.Among them,23 patients were treated with locking plate internal fixation in the first stage(internal fixation group),16 patients were treated with locking compression plate external fixation(external fixation group),and both groups were treated with intramedullary nail internal fixation in the second stage of bone graft.The infection control rate,bone healing rate,healing time and postoperative ankle function score of the American Society of Foot and Ankle Surgery(AOFAS)were compared between the two groups.Results All patients were followed up for 30 to 86 months,there was no statistically significant difference in postoperative infection control rate,bone healing rate,healing time,and ankle joint function score of AOFAS between the two groups(P>0.05).Conclusion The induced membrane technique can achieve satisfactory curative effect in the treatment of distal tibial osteomyelitis after trauma by using locking plate internal fixation and locking compression plate external fixation,which does not increase the recurrence rate of infection by using locking plate internal fixation in the first stage surgery.

关 键 词：胫骨 创伤 骨髓炎 膜诱导技术 稳定方式 

分 类 号：R681.2[医药卫生—骨科学]