桥接外固定系统治疗胫骨慢性骨髓炎疗效分析  

Clinical efficacy of ortho-bridge system in the treatment of chronic osteomyelitis of the tibia

作　　者：王石林 钟文龙 郭再冉 杨瑞芳 卢承印 张磊 王新卫 WANG Shilin;ZHONG Wenlong;GUO Zairan;YANG Ruifang;LU Chengyin;ZHANG Lei;WANG Xinwei(Department of Bone and Joint Infection,Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Henan,Luoyang 471002,China;Henan University of Chinese Medicine Luoyang Pingle Orthopaedic College,Zhengzhou 450046,China)

机构地区：[1]河南省洛阳正骨医院(河南省骨科医院)骨与关节感染一科,河南洛阳471002 [2]河南中医药大学洛阳平乐正骨学院,河南郑州450046

出　　处：《中国现代医生》2022年第27期25-28,共4页China Modern Doctor

基　　金：河南省科技攻关计划项目(182102310487)。

摘　　要：目的探讨桥接外固定系统治疗胫骨慢性骨髓炎的临床疗效。方法回顾性分析2016年6月至2021年9月于河南省洛阳正骨医院(河南省骨科医院)骨与关节感染诊疗中心采用桥接外固定系统治疗的27例胫骨慢性骨髓炎患者,所有患者均彻底清创后采用桥接组合外固定系统联合抗生素人工骨填充治疗。记录患者治疗前后C反应蛋白、红细胞沉降率、白细胞,骨愈合时间,外固定佩戴时间,钉道感染发生率,末次随访根据慢性骨髓炎疗效标准评定疗效。结果27例患者均获随访,随访时间25~31个月,平均(27.97±1.68)个月;骨愈合时间8~12个月,平均(9.74±1.16)个月;外固定佩戴时间12~15个月,平均(13.61±0.94)个月;钉道感染发生率14.8%(4/27)。3例患者出现骨折不愈合,行自体髂骨植骨治疗后愈合。末次随访时,所有患者骨髓炎均未复发,痊愈18例,好转9例。结论桥接外固定系统治疗胫骨慢性骨髓炎具有损伤小、多维固定、方便佩戴、临床疗效满意的优点,是治疗胫骨慢性骨髓炎的有效方法。Objective To explore the clinical efficacy of ortho-bridge system in the treatment of chronic osteomyelitis of the tibia.Methods A retrospective analysis of 27 patients with chronic osteomyelitis of the tibia in the Osteomyelitis Treatment Center,Luoyang Orthopaedic-Traumatoloical Hospital of Henan Province(Henan Provincial Orthopaedic Hospital)were treated with a bridging external fixation system from June 2016 to September 2021,all patients were treated with a bridging combination external fixation system combined with antibiotic artificial bone filling after thorough debridement.C-reactive protein,erythrocyte sedimentation rate,white blood cell bone healing time,external fixation wearing time,incidence of nail tract infection were recorded before and after treatment,and the efficacy was evaluated according to the chronic osteomyelitis efficacy criteria at the last follow-up.Results Twenty-seven patients were followed up for 25 to 31 months with a mean of(27.97±1.68)months,bone healing time was 8 to 12 months with a mean of(9.74±1.16)months,external fixation wearing time was 12 to 15 months with a mean of(13.61±0.94)months,and the incidence of nail tract infection was 14.8%(4/27).Three patients had non-healing fractures,which healed after treatment with autologous iliac bone graft.At the time of final follow-up,all patients had no recurrence of osteomyelitis,with 18 cases healed and 9 cases improved.Conclusion The bridging external fixation system is an effective method for treating chronic osteomyelitis of the tibia with the advantages of less injury,multidimensional fixation,easy wear,and satisfactory clinical efficacy.

关 键 词：桥接固定系统 外固定 胫骨骨髓炎 慢性骨髓炎 

分 类 号：R681[医药卫生—骨科学]