骨搬移治疗外伤性胫骨骨髓炎伴大段骨缺损的疗效观察.pdfVIP

山西医科大学硕士学位论文 Clinicalobservationofbonetransporttreatingtraumatictibia osteomyelitiswithbonedefect Abstract Objective: Toinvestigatethee icacyo thetraumatictibiaosteomyelitisbybonetransport. Methods: A retrospective analysis 20 cases tibia osteomyelitis ,by the Ilizarov circular ring fixatorreconstructingbone lossfollowingdebridement ,fromFeb2010toJuly2013.Male 15cases, female 5 cases, debridement bone defect length is 6-10 cm, 8 cm on average. Postoperative patients regular review adjust the lines o force, encourage them complete andfullweightbearing. Results: 20patients received 16months to 40 months (average 22.0 months) follow-up。16 patients docking site directly bone union , the rest o the docking site failed to directly boneunion.Byiliacbonegraftandinternalfixationwithsteelplateboneunion.Theextend lengthis6to 10cm(average8cm).Externalfixatorindexfor 1.5-2months/cm.According toPaleyboneunioncriteria:14casesexcellent,5casesgood,and1casepoor. Conclusions: Tibia bone transport treatment o traumatic osteomyelitis is safe and e ective. Why the docking site can’t directly union ,Now the mechanism and the exact cause are still unclear.Butaftercompleteweightbearingandpost-processingstructedboneunion. II 山西医科大学硕士学位论文 Keywords:bonetransport;Ilizarovcircularringfixator;dockingsiteununion; tibiaosteomyelitis III 山西医科大学硕士学位论文 前 言 外伤性骨感染是临床常见的骨科疾病，关于骨感染的诊治，学者们有很多治疗经 [1] 验的总结 。其中对于外伤性胫骨骨髓炎彻底的治疗是采取手术方式。常需彻底广泛 清除无活力的死骨及周围坏死组织，最终导致大段骨缺损，使得骨感染的疾病治疗更 加棘手。当前文献报道的治疗方式有一期取自身髂骨植骨术，带血管的自身腓骨骨肌 [2-6] [7] 瓣移植，诱导膜技术 （Masquelettechnique)，骨搬移技术 以及开放