距下关节截骨牵伸融合新方法治疗陈旧性跟骨关节-第三军医大学学报.docVIP

骨搬移技术治疗下肢感染性骨缺损 李维 王子明 杜全印 王雨 熊雁 王爱民* （第三军医大学大坪医院野战外科研究所关节四肢外科，重庆 400042） 【摘要】 目的 探讨应用骨搬移技术治疗严重下肢感染性骨不连的临床疗效。方法 按照牵拉组织再生原理，对26例四肢高能量损伤后下肢感染性骨不连患者采取病灶彻底切除+干骺端截骨搬移术。术后7d以0．25mm/6 h速度延长，固定延长至骨缺损端会合，于骨缺损处两断端加压并继续维持外同定支架至骨愈合。结果 26例全部获随访，时间20～92个月，平均56个月 。骨延长2～14cm，平均5.5cm，骨性感染全部治愈。带支架时间6～24个月，平均13个月。23例骨缺损处及延长部位骨生长良好，达到了骨性愈合；3例断端骨接触后6个月无明显骨愈合，2例行自体髂骨植骨、1例拆除支架后行自体髂骨植骨内固定，4～6个月达到骨性愈合。截骨延长部位及骨缺损对合处对位对线良好。结论 骨搬移技术治疗下肢感染性骨不连，术后感染控制良好，骨愈合率高。 【关键词】 骨搬移；骨延长；骨髓炎；外固定 中图分类号:R681.2；R687.3 Bone transport technique in the treatment of infected bone defect of lower limbs Li Wei,Wang Ziming,Du Quanyin,et al. (Department of Orthopedics，Institute of Surgery Research，Daping Hospital，Third Military Medical University，Chongqing 400042，China) 【Abstract】 Objective To investigate the clinical efficacy of the treatment of severe lower extremity infected bone nonunion by bone transport technique.Methods according to the principle of distraction histogenesis, 26 cases of high energy injury lower extremity infected bone nonunion were treated by complete focal excision and metaphyseal osteotomy transport technique. After 7days are extended to 0.25mm / 6 h ___________________________________ 通讯作者：王爱民，电话：（023E-mail：trauma2@163.com speed, fixed extended to bone defect. In the end, the bone defect in the two ends and continue to maintain the pressure outside the fixed bracket to the bone healing. Results The 26 cases were all followed up, time 20 ~ 92 months, average 56 months. Bone lengthening was 2 ~ 14cm, average 5.5cm, bony infection cured. With support from 6 to 24 months, average 13 months. 23 cases of bone defect and prolonged bone growth is good, bony union was achieved. in 3 cases of bone exposure, broken ends after 6 months without obvious bone healing, 2 cases of autologous iliac bone graft, 1 cases of stent removal after autologous iliac bone graft and internal fixation, 4 to 6 months to achieve bone healing. Osteotomy site and bone defect of place of counterpo