Ilizarov技术治疗感染性胫骨缺损伴垂足畸形  

Ilizarov technique for treatment of infectious tibial defect complicated with foot drop

作　　者：赵殿钊 杨华清[1] 郑学健 章耀华[1] 韩庆海[1] 彭爱民[1] 杨云[1] 杨启昌 ZHAO Dian-zhao;YANG Hua-qing;ZHENG Xue-jian;ZHANG Yao-hua;HAN Qing-hai;PENG Ai-min;YANG Yun;YANG Qi-chang(Department of Orhopedis,Beijing Rehabiliation Hospital,Capital Medical Universiy,Bejing 100144,China;Department of Orthopaedic Surgery,Affiliated Rehabliation Hospital,National Rehabilitation and Aid Device Research Center,Bejing 100176,China)

机构地区：[1]首都医科大学附属北京康复医院骨科,北京100144 [2]国家康复辅具研究中心附属康复医院矫形外科,北京100176

出　　处：《中国矫形外科杂志》2022年第14期1335-1338,共4页Orthopedic Journal of China

基　　金：首都卫生发展科研专项(编号:2022-2-2253);北京市石景山区医学重点专科建设项目。

摘　　要：[目的]探讨Ilizarov技术同期治疗胫骨感染性骨缺损伴垂足畸形的临床疗效。[方法]2013年1月—2020年9月对45例胫骨感染性骨缺损伴垂足畸形行病灶清理、病变骨段切除、Ilizarov外固定器骨搬移、足部牵拉矫形,总结临床与影像结果。[结果]所有患者顺利完成手术,无重要血管、神经损伤。创面愈合时间(36.22±11.24)d,外架调整时间(3.26±1.32)个月,骨搬移长度(6.74±3.26)cm,骨缺损愈合时间(20.22±5.84)个月。随访时间(28.6±12.4)个月,随时间推移,VAS评分显著下降(P<0.05),AOFAS评分和踝关节ROM显著增加(P<0.05)。影像方面,随时间推移,胫骨干成角畸形显著矫正(P<0.05),mMPT和mLDTA均无显著改变(P>0.05),双侧胫骨长度差显著减小(P<0.05),所有患者骨缺损及截骨处均骨性愈合。[结论]采用Ilizarov技术同期治疗骨髓炎、修复骨大段缺损和矫正垂足畸形临床效果良好。[Objective]To investigate the clinical efficacy of Ilizarov technique for simultaneous treatment of tibial infectious bone defect accompanied with foot drop.[Methods]From January 2013 to September 2020,45 patients received debridement,resection of infected bone segment,bone transport and foot stretch correction by Ilizarov external fixator for infectious tibial bone defect complicated with foot drop deformity.The clinical and imaging results were summarized.[Results]All patients were successfully operated on without any important vascular or nerve injury,while with wound healing time of(36.22±11.24)days,the external frame adjustment time of(3.26±1.32)months,the bone transport length of(6.74±3.26)cm,and the bone defect healing time of(20.22±5.84)months.As time went in the followup lasted for(28.6±12.4)months,the VAS score decreased significantly(P<0.05),whereas the AOFAS score and ankle ROM increased significantly(P<0.05).Radiographically,the tibial shaft angulation was corrected significantly over time(P<0.05),whereas the mMPT and mLDTA remained unchanged(P>0.05),and the discrepancy in bilateral tibial length was significantly decreased(P<0.05),with bony healing of the bone defects and osteotomy sites finally in all patients.[Conclusion]The Ilizarov technique does achieve satisfactory clinical outcomes for treating osteomyelitis,repairing large bone defect and correcting foot drop simultaneously.

关 键 词：胫骨感染性骨缺损 垂足 ILIZAROV技术 骨搬移 牵张矫正 

分 类 号：R683.42[医药卫生—骨科学]