Ⅰ期自体松质骨移植修复胫骨创伤后骨髓炎骨缺损的临床研究.docVIP

PAGE PAGE 4 Ⅰ期自体松质骨移植修复胫骨创伤后骨髓炎骨缺损的临床研究 喻胜鹏，杨子洋，傅景曙，黄 科，谢 肇 （400038 重庆，第三军医大学西南医院骨科, 全军矫形外科中心） ［摘要］目的 探讨Ⅰ期自体松质骨治疗胫骨创伤后骨髓炎骨缺损的临床疗效。方法 回顾性分析2010年1月至2012年09月收治的18例胫骨骨髓炎患者，包括11例感染性骨不连。彻底清创后Ⅰ期移植颗粒状自体松质骨，外置锁定钢板作为外固定支架。结果 18例患者随访12～34个月，平均21个月。其中15例获得骨愈合；2例患者同时发生炎症复发和骨吸收；1例骨不连患者获得骨愈合但需要再次清创；2例患者发生钉道感染，其中1例同时发生骨吸收需要再次植骨。结论 有选择的行Ⅰ期自体松质骨移植治疗胫骨创伤后骨髓炎可以取得良好的临床效果。 ［关键词］骨髓炎；外固定架；自体，移植 [中图法分类号] [文献标志码] A Single stage treatment of tibial post-traumatic osteomyelitis bone defects with autologous cancellous bone grafting Shengpeng Yu, Ziyang Yang, Jingsu Fu, Ke Huang, Xie Zhao (Center of Orthopedics, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China ) ［Abstract］ Objective Discussion the clinical outcome of single stage autologous cancellous bone grafting to treat tibial post-traumatic osteomyelitis. Methods We retrospectively analyzed 18 patients with tibial post-traumatic osteomyelitis from January 2010 to Sepetember 2012, including 11 infected nonunion patients. Autologous granulated cancellous bone was grafted after radical debridement, and using a locking compression plate as an external fixator to stabilize the bone. Results 18 patients at a mean follow up of 21 months (range from 12 to 34). 15 patients acquired bone union; bone absorbtion and infection recurrence was observed in 2 patients; bone union was aquired in 1 patient but needed another debridement; pin track infection occurred in 2 patients and one of the cases needed another debridement and bone grafting. Conclusion Using single stage bone grafting selectively to treat tibial post-traumatic osteomyelitis can acquire good clinical outcome. ［Key words］osteomyelitis; external fixator; transplantation, autologous Corresponding author: Xie Zhao, E-mail: xiezhao54981@163.com ［通信作者］ 谢 肇, E-mail: xiezhao54981@163.com 创伤后骨髓炎常继发于高能量损伤所致的下肢骨折，以胫骨最为常见。胫骨创伤后骨髓炎易复发、难治疗，特别是因抗生素长期滥用导致的泛耐药菌感染引起的骨髓炎。生物膜细菌在死骨和内固定表面生长繁殖是导致炎症反复发作的主要原因 ADDIN EN.CITE EndNoteCiteAuthorCosterton