抗生素骨水泥柱占位联合植骨治疗股骨远端开放骨折骨缺损的疗效分析  

Treatment of open fracture bone defect of distal femur with antibiotic cement column and bone graft

作　　者：乔跃跃 赵勇 周大鹏 解冰 薛海鹏 QIAO Yue-yue;ZHAO Yong;ZHOU Da-peng;XIE Bing;XUE Hai-peng(Department of Orthopaedics,North Theater General Hospital,Shenyang 110016,Liaoning,China)

机构地区：[1]北部战区总医院骨科,辽宁沈阳110016

出　　处：《中国骨伤》2024年第4期406-410,共5页China Journal of Orthopaedics and Traumatology

基　　金：辽宁省民生科技计划项目(编号:2021JH2/10300057)。

摘　　要：目的:探讨抗生素骨水泥柱占位联合髂骨植骨在股骨远端开放骨折骨缺损治疗中的有效性及初步疗效。方法:回顾性分析2014年10月至2021年3月采用抗生素骨水泥柱占位联合髂骨植骨技术治疗股骨远端开放骨折骨缺损16例,其中男12例,女4例;年龄28~68岁。车祸伤11例,高处坠落伤5例,Gustilo分型Ⅰ型3例,Ⅱ型5例,ⅢA型8例。采用AO分型:C2型9例,C3型7例。从受伤至接受最终植骨手术时间为4~119 d。骨缺长损度2~10 cm。记录患者骨折愈合时间、并发症、膝关节功能Merchan评分。结果:本组16例患者均获得随访,随访时间9~29个月。16例患者切口均Ⅰ期愈合,无术后感染、钢板断裂、肢体短缩及膝内外翻畸形等并发症。骨折愈合时间为4~10个月。膝关节功能根据Merchan评分标准评估,优8例,良4例,可3例,差1例。结论:采用抗生素骨水泥柱占位联合髂骨植骨治疗股骨远端开放复杂骨折骨缺损有助于预防感染、协助骨折复位,增加固定强度,减少植骨量,是一种有效的手术方式。Objective To investigate the efficacy of antibiotic cement column combined with iliac bone graft in the treatment of open fracture with bone defect of distal femur.Methods From October 2014 to March 2021,16 patients of open fracture bone defect of distal femur were treated with antibiotic bone cement column and iliac bone graft,including 12 males and 4 females.The age ranged from 28 to 68 years old.There were 11 cases of traffic accident injury,5 cases of falling injury,3 cases as Gustilo typeⅠ,5 cases as typeⅡand 8 cases as typeⅢA.AO classification was used:9 cases of C2 type and 7 cases of C3 type.The time from injury to final bone grafting ranged from 4 to 119 days.The length of bone defect ranged from 2 to10 cm.Fractures healing time,complications and knee function Merchan score were recorded.Results All the 16 patients were followed up from 9 to 29 months.The incisions of 16 patients healed in one stage without postoperative infection,plate fracture,limb shortening and valgus and varus deformity.The healing time randed from 4 to 10 months.Knee joint function according to the Merchant scoring standard,showed that 8 cases were excellent,4 cases were good,3 cases were fair,and 1 case was poor.Conclusion The use of antibiotic bone cement column combined with iliac bone graft in the treatment of open and complex bone defects of distal femur is an effective surgical method to prevent infection,assist fracture reduction,increase fixation strength and significantly reduce the amount of bone grafting.

关 键 词：股骨远端复杂骨折 骨缺损 抗生素骨水泥 植骨 

分 类 号：R683.42[医药卫生—骨科学]