Ilizarov技术在治疗胫骨骨髓炎中的应用  

Application of Ilizarov technique in the treatment of tibial osteomyelitis

作　　者：范金柱 杨成 任小宇 从飞 宋涛 Fan Jinzhu;Yang Cheng;Ren Xiaoyu(Microsurgical Repair Department of Orthopaedics,the Affiliated Honghui Hospital of Xi"an Jiaotong University,Xi'an 710054,China)

机构地区：[1]西安市红会医院骨显微修复外科,710054

出　　处：《美中国际创伤杂志》2024年第1期21-22,44,共3页U.S.Chinese International Journal of Traumatology

摘　　要：目的:探讨Ilizarov技术治疗胫骨骨髓炎的临床疗效。方法:回顾性分析2018年2月至2023年5月收治的46例合并软组织损伤的胫骨缺损患者资料,其中男38例,女8例;年龄18~65岁,平均37岁;损伤按照Gustilo分型:ⅢIB型44例,ⅡC型2例;软组织缺损面积10cm×5cm-20cm×30cm;胫骨干缺损长度7-16cm,平均14cm。根据胫骨骨与软组织缺损部位及创面大小选择Ilizamv技术的3种不同治疗方案:创面开放换药结合骨搬运术治疗19例,肢体短缩后骨折端加压骨延长术治疗10例,组织瓣移植结合骨搬运术或骨延长术治疗17例。结果:所有患者术后获10~30个月(平均24个月)随访,骨搬运或延长距离4~15cm(平均10.8cm);平均骨搬运速度1mmd。46例患者胫骨全部愈合,外固定时间10-20个月,平均15.3个月。根据Paley评分标准评价功能:优22例,良16例,可7例,差1例,优良率为86%。结论:lizarov技术治疗胫骨骨髓炎可取得较好的临床疗效。Objective:To investigate the clinical effect of Ilizarov technique in the treatment of tibial osteomyelitis.Methods:The data of 46 cases of tibia defect with soft tissue injury from February 2018 to May 2023 were analyzed retrospectively,including 38 males and 8 females,aged from 18 to 65 years with an average of 37 years.According to Gustilo classification,there were 44 cases of type IB and 2 cases of type IIC,the defect area of soft tissue was 10cm×5cm-20cm×30cm,the length of tibia shaft defect was 7-16cm with an average of 14cm.According to the defect of tibia and soft tissue and the size of the wound,three different treatment regimens of Ilizamv technique were selected:open dressing change combined with bone transfer in 19 cases;compression bone lengthening after limb shortening in 10 cases and tissue flap transplantation combined with bone transport or bone lengthening in 17 cases.Results:All patients were followed up for 10-30 months(mean 24 months),and the bone transport or extension distance was 4-15cm(mean 10.8cm).The average bone transport speed is lmm/d.The tibia of 46 patients healed completely and the time of external fixation was 10-20 months(average 15.3 months).According to the Paley scoring standard,22 cases were excellent,16 cases were good,7 cases were fair and 1 case was poor,with an excellent and good rate of 86%.Conclusion:Ilizarov technique can achieve a good clinical effect in the treatment of tibial osteomyelitis.

关 键 词：胫骨骨髓炎 外固定架 ILIZAROV技术 

分 类 号：R68[医药卫生—骨科学]