骨水泥栓植入联合关节融合术治疗累及关节的指骨骨髓炎  

Bone cement plug implantation combined with arthrodesis for the treatment of phalange osteomyelitis involving joint

作　　者：张光辉[1] 张清林[1] 张磊[1] 韩清銮[1] ZHANG Guanghui;ZHANG Qinglin;ZHANG Lei(Department of Hand and Foot Surgery,Affiliated Hospital of Jining Medical College,Jining,Shandong,272000,China)

机构地区：[1]济宁医学院附属医院手足外科,山东济宁272000

出　　处：《实用手外科杂志》2021年第3期286-288,308,共4页Journal of Practical Hand Surgery

基　　金：济宁市科技局医养健康基金(项目编号:2018SMNS002)。

摘　　要：目的总结带病原菌敏感抗生素骨水泥栓植入联合关节融合治疗累及关节的指骨骨髓炎的临床疗效,为累及指间关节的指骨骨髓炎提供一种有效的治疗方案。方法 2012-2016年,收治20例指骨骨髓炎患者,一期行切开引流负压吸引(vacuum sealing drainage, VSD),无明显脓液后,10例(观察组)行带病原菌敏感抗生素骨水泥栓植入骨髓腔联合指间关节融合术治疗,另外10例(对照组)行指间关节融合术治疗,其中3例伴皮肤软组织缺损,同时行局部转移皮瓣或指动脉岛状皮瓣修复。结果本组20例术后均获得随访,平均随访21个月。观察组总有效率100%,对照组总有效率70%,两组比较具有统计学意义。结论对于累及指间关节的指骨骨髓炎,应用带病原菌敏感抗生素骨水泥栓植入联合关节融合手术治疗,效果满意,不易复发。Objective To summarize the clinical efficacy of pathogenic bacteria sensitive antibiotic bone cement insert combined with interphalangeal arthrodesis to provide an effective treatment for implicated phalange osteomyelitis.Methods From 2012 to 2016,our department had treated 20 patients with implicated phalange osteomyelitis,all patients had obvious redness,heat and pain,ulceration,pus and other symptoms before the operation.X-ray showed bone destruction at the phalangeal joint and hardening of the phalanx.All patients underwent vacuum sealing drainage(VSD)treatment in the first stage.In the second stage,after the injury had no obvious pus,10 patients(as treatment group)underwent pathogenic bacteria sensitive antibiotic bone cement insert combined with interphalangeal arthrodesis,and 10 patients(as control group)directly underwent interphalangeal arthrodesis treatment.Among them,3 cases had skin and soft tissue defects while undergoing repair of local transfer flap or finger artery island flap treatment.Results All patients were followed up for an average of 21 months.The total effective rate was 100%in the treatment group and 70%in the control group.Two groups were statistically significant.Conclusion The application of pathogenic bacteria sensitive antibiotic bone cement insert combined with interphalangeal arthrodesis in the treatment of implicated phalange osteomyelitis is satisfactory and not easy to relapse.

关 键 词：骨髓炎 骨水泥栓 关节融合术 指间关节 

分 类 号：R687.3[医药卫生—骨科学]