本文選題：Masquelet技術(shù) + 慢性骨髓炎��； 參考：《浙江大學(xué)》2015年碩士論文

【摘要】：目的：探討應(yīng)用Masquelet技術(shù)治療慢性骨髓炎后大段骨缺損的早期療效。 方法：回顧性分析2010年12月至2014年12月收治的4例慢性骨髓炎后大段骨缺損患者資料,男3例,女1例；年齡37-72歲,平均56.5歲。骨缺損長(zhǎng)度5.4cm-11.2cm,平均7.1cm。所有患者均采用Masquelet技術(shù)分2個(gè)階段治療：第1階段先要進(jìn)行徹底的清創(chuàng),外固定架或鋼板外固定固定患肢,將混有10%萬古霉素或泰能的聚甲基丙烯酸甲酯(PMMA)骨水泥塑形后填充于骨缺損部位,最后無張力關(guān)閉創(chuàng)面,第2階段,切開并逐層分離軟組織后,小心切開誘導(dǎo)膜,取出里面的骨水泥,然后在誘導(dǎo)膜腔里充填移植骨,逐層關(guān)閉。記錄患肢術(shù)后并發(fā)癥、骨愈合時(shí)間及功能情況。 結(jié)果：所有患者術(shù)后獲3-16個(gè)月(平均9個(gè)月)隨訪,切口4例愈合,無再發(fā)切口感染,無再發(fā)骨髓炎征象,無供區(qū)并發(fā)癥,無術(shù)后再發(fā)骨折發(fā)生等需計(jì)劃外手術(shù)。4例最終采用外固定架2例,鋼板外固定2例,1例植骨中加入BMP。1例骨已愈合,患者影像學(xué)上示少許橫向移位伴畸形愈合,未予特殊處理,功能良好,末次隨訪時(shí),可完全負(fù)重行走,步態(tài)基本正常。1例影像學(xué)上骨已愈合,創(chuàng)口愈合良好,無疼痛,目前可拄拐部分負(fù)重行走。其余2例,影像學(xué)上可見骨痂生長(zhǎng),末次隨訪時(shí),創(chuàng)口愈合良好,可拄拐部分負(fù)重行走,無疼痛。 結(jié)論：Masquelet技術(shù)可以有效地治療長(zhǎng)骨慢性骨髓炎清創(chuàng)后大段骨缺損問題,具有操作簡(jiǎn)便、并發(fā)癥少等特點(diǎn)。
[Abstract]:Objective: to investigate the early efficacy of Masquelet in the treatment of large bone defect after chronic osteomyelitis.Methods: the data of 4 patients with massive bone defect after chronic osteomyelitis from December 2010 to December 2014 were retrospectively analyzed, including 3 males and 1 female, with a mean age of 56.5 years (37-72 years).The length of bone defect was 5.4 cm to 11.2 cm, with an average of 7.1 cm.All patients were treated with Masquelet technique in two stages: stage 1, complete debridement, external fixation or plate fixation.The bone cement mixed with 10% vancomycin or tetracycline (PMMA) was molded and filled in the bone defect area. Finally, the wound was closed without tension. In the second stage, after cutting and separating the soft tissue layer by layer, the induction membrane was cut carefully.Take out the bone cement and fill in the induction chamber and close the graft layer by layer.Postoperative complications, bone healing time and function were recorded.Results: all the patients were followed up for 3-16 months (mean, 9 months). The incision healed in 4 cases, no recurrent wound infection, no sign of recurrent osteomyelitis, no complications in donor area.There were 2 cases of external fixator, 2 cases of external fixation, 2 cases of bone union with BMP.1 in 1 case of external fixation with steel plate, and a little lateral displacement with malunion on imaging, but no special treatment.The function was good. At the last follow-up, the body could walk with full load, and the gait was basically normal in 1 cases. The bone healed, the wound healed well, and there was no pain. At present, it was possible to walk with the aid of a crutch.The other 2 cases showed callus growth on imaging. At the last follow-up, the wound healed well and could walk on crutches partly with no pain.Conclusion: the technique of 10% Masquelet is effective in the treatment of large segment bone defect after debridement of chronic osteomyelitis of long bone, which has the advantages of simple operation and less complications.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

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相關(guān)期刊論文 前3條

1 喻勝鵬;傅景曙;李偉;黃科;黃強(qiáng);謝肇;;Masquelet技術(shù)治療長(zhǎng)骨骨髓炎骨缺損的臨床分析[J];第三軍醫(yī)大學(xué)學(xué)報(bào);2014年15期

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本文編號(hào)：1741593