Masquelet技术联合抗生素骨水泥涂层髓内钉治疗胫骨干感染性骨不连疗效观察  

Antibiotics bone cement coating intramedullary nail combined with Masquelet technique for tibial infectious bone nonunion

作　　者：杨超 刘兵 马翔宇 韩宁 薛海鹏 王冠 张志文 韩天宇 YANG Chao;LIU Bing;MA Xiang-yu;HAN Ning;XUE Hai-peng;WANG Guan;ZHANG Zhi-wen;HAN Tian-yu(Department of Orthopedics,Army severe trauma treatment center,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院骨科全军重症战创伤救治中心,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2023年第3期162-164,169,共4页Trauma and Critical Care Medicine

基　　金：辽宁省民生科技计划项目(2021JH2/10300057)。

摘　　要：目的探讨抗生素骨水泥涂层髓内钉联合Masquelet技术治疗胫骨开放骨折术后感染性骨不连的临床疗效。方法回顾性分析自2019年1月至2021年12月北部战区总医院骨科收治的18例胫骨开放骨折术后感染性骨不连患者的临床资料。所有患者均接受抗生素骨水泥涂层髓内钉联合Masquelet技术治疗。记录患者围术期指标、愈合时间、随访期间并发症发生情况等。结果围术期患者清创后骨缺损长度为4.00~8.00 cm,平均长度(6.20±1.18)cm;手术次数为(2.2±1.4)次。患者的C-反应蛋白术前为(64.8±13.1)mg/L,显著高于术后的(10.1±8.5)mg/L;红细胞沉降率术前为(56.1±12.4)mm/h,显著高于术后的(14.9±4.2)mm/h,差异均有统计学意义(P<0.05)。患者均获得15~28个月的随访。18例患者骨折均愈合,愈合时间7~15个月;患者无感染和明显畸形。结论抗生素骨水泥涂层髓内钉联合Masquelet技术治疗胫骨开放骨折术后感染性骨不连时,可通过防止感染扩散,丰富局部血供等,使骨缺损快速愈合,达到临床治愈目的。Objective To investigate the clinical effect of antibiotic bone cement coating intramedullary nail combined with Masquelet technique for tibial infectious bone nonunion.Methods A retrospective study was performed on 18 cases of patients with postoperative infectious bone nonunion of tibial fracture who were admitted from January 2019 to December 2021.All the patient receved the treatment of antibiotic bone cement coating intramedullary nail combined with Masquelet technique.The patients perioperative index,time of healing and complications during follow-up were recorded.Results During the perioperative period,the length of bone defect of the patiens was 4.00-8.00 cm and the mean lengh was(6.20±1.18)cm.The average surgical times was(2.2±1.4)with the follow-up of 15-28 months.The C-reactive protein was(64.8±13.1)mg/L before surgery,significantly higher than that after surgery(10.1±8.5)mg/L.The erythrocyte sedimentation rate before surgery(56.1±12.4)mm/h was significantly higher than that after surgery(14.9±4.2)mm/h,the differences were statistically significant(P<0.05).In 18 cases,all the fracture healed with the healing time was 7-15 months.The patients was free of infection and significant deformity occurred.Conclusions Antibiotic bone cement coating intramedullary nail combined with Masquelet technique for tibial infectious bone nonunion can effectively prevent infection and enrich local blood supply,so that the bone defect can heal quickly.

关 键 词：抗生素骨水泥涂层 髓内钉 Masquelet技术 胫骨开放骨折 感染性骨不连 

分 类 号：R683[医药卫生—骨科学]