Masquelet技术在感染性指骨大段骨缺损治疗中应用.docxVIP

Masquelet技术在感染性指（掌）骨大段骨缺 损治疗中应用 【摘要】目的：探讨Masquelet技术在修复感染性 指（掌）骨大段骨缺损中的临床应用及疗效。方法：自2008 年1月-2013年1月，感染性指（掌）骨大段骨缺损患者应 用Masquelet技术，结合或不结合皮瓣修复指（掌）骨大段 骨缺损21例。21例患者均为一期清创或内固定手术后感染, 其中金黄色葡萄球菌感染者13例，链球菌7例，铜绿假单 胞菌感染者1例。应用Masquelet技术，一期手术彻底清创 后抗生素骨水泥占位填充骨缺损，6?8周后二期手术取出骨 水泥，置入自体松质骨，修复骨缺损长度为11?33 mm,平 均19 mm。结果：21例中手术成功20例，1例失败，原因为 拇指近节指骨一期手术术后再次感染，后行再次清创、拇指 短缩、关节融合术。手术成功者18例获得随访，失访2例。 随访时间平均7个月。18例感染性指（掌）骨缺损患者中食 指侧方皮瓣覆盖者3例，术后创面一期愈合18例，愈合时 间10?15 d,二期手术后骨愈合时间2. 6?3. 5个月，平均 愈合时间2. 8个月，患指功能恢复满意。结论：Masquelet 技术在修复感染性指（掌）骨大段骨缺损中效果良好。 【关键词】Masquelet技术；感染；骨缺损；骨修 中图分类号R658文献标识码A文章编号1674-6805 (2013) 33-0001-04 The Clinical Application of Masquelet Technique in the Treatment of Large Segmental Infective Phalanges or Metacarpal Defects/ZHAO Li-ning, TIAN Qing-ye, WANG Jian-guo. //Chinese and Foreign Medical Research, 2013, 11 (33)： 1-4 [Abstract] Objective： To study effect of large segmental bone defects of phalanges (metacarpal) with Masquelet technique? Method : From January 2008 to January 2013, 21 cases were therapied by Masquelet technique, with skin flap or not. All cases were infected after a debridement or internal fixation, including 13 cases of Staphylococcus aureus infection, 7 cases of streptococcal infection, and 1 case of Pseudomonas aeruginosa infection. Masquelet technique involved a two~step procedure? First, bone cement was used to fill the bone defect after a thorough debridement； then the bone cement was removed after 6-8 weeks , and rich cancellous bone was impla nted into the bone defect.Repairing the length of bone defect was vary from 11 mm to 33 mm (average 19 mm) . ResuIt： 20 cases were cured with the clinical application of Masquelet technique, 1 case was failed, due to an re-infection after the first surgery, then underwent debridement, thumb shortening and arthrodesis? 18 cases were followed up, 2 cases were lost .The average followup times were 7 months? In the 18 cases, 3 cases of bone defect fingers were repaired with side flap, 18 cases of wound skin w