【摘要】：目的比較Ilizarov骨搬運(yùn)技術(shù)與鎖定加壓接骨板(LCP)結(jié)合植骨內(nèi)固定治療下肢感染性骨不連的臨床療效。方法回顧性分析自2010-07—2015-04診治的感染性骨不連22例,首先給予清創(chuàng)、VSD負(fù)壓吸引及抗生素鏈珠置入控制感染,待感染控制良好后,進(jìn)行Ilizarov骨搬運(yùn)技術(shù)(骨搬運(yùn)組11例)或LCP結(jié)合植骨內(nèi)固定(LCP組11例)治療。比較2組術(shù)中失血量、手術(shù)次數(shù)、感染控制率、住院時(shí)間、術(shù)后至開(kāi)始部分負(fù)重時(shí)間及末次隨訪時(shí)AAOS評(píng)分。結(jié)果所有患者均獲得隨訪3~35個(gè)月,平均24.2個(gè)月。末次隨訪時(shí)骨搬運(yùn)組4例完全愈合恢復(fù),7例感染消除,骨搬運(yùn)已結(jié)束,處于骨愈合期;1例發(fā)生針道感染,常規(guī)換藥加抗生素治愈。LCP組8例已完全恢復(fù),3例出現(xiàn)感染,再次行手術(shù)治療。與LCP組比較,骨搬運(yùn)組術(shù)中失血量及手術(shù)次數(shù)較少,感染控制率更高,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2組住院時(shí)間、術(shù)后至開(kāi)始部分負(fù)重時(shí)間、AAOS評(píng)分比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 Ilizarov骨搬運(yùn)技術(shù)治療下肢感染性骨不連的感染控制率高,且能夠有效保護(hù)軟組織,促進(jìn)其恢復(fù),為肢體恢復(fù)長(zhǎng)度提供保障。
[Abstract]:Objective to compare the clinical effect of Ilizarov bone transport technique and locking compression plate (LCP) combined with bone graft internal fixation in the treatment of infective bone nonunion of lower extremity. Methods 22 cases of infectious nonunion diagnosed and treated from 2010-07 to 2015-04 were retrospectively analyzed. First, debridement, VSD suction and antibiotic beads were performed to control the infection. Ilizarov bone transport technique (11 cases) or LCP combined with bone graft internal fixation (LCP group 11 cases) were performed. The amount of blood loss, the times of operation, the infection control rate, the time of hospitalization, the time of partial weight bearing from operation to the beginning of operation and the AAOS score at the last follow-up were compared between the two groups. Results all the patients were followed up for 3 ~ 35 months with an average of 24.2 months. At the last follow-up, 4 cases in the bone transport group recovered completely, 7 cases got rid of the infection, and the bone transport was finished, which was in the period of bone healing. One case developed needle infection and was cured by routine dressing change and antibiotics. In LCP group, 8 cases were completely recovered, 3 cases were infected and underwent surgical treatment again. Compared with LCP group, the amount of blood loss and the times of operation were less in bone handling group, and the infection control rate was higher (P0.05). There was no significant difference in AAOS score (P0.05). Conclusion the infection control rate of Ilizarov in the treatment of infective bone nonunion of lower extremity is high, and it can effectively protect soft tissue, promote its recovery and provide guarantee for the length of limb recovery.
【作者單位】： 吉林大學(xué)第一醫(yī)院創(chuàng)傷骨科;吉林省中醫(yī)院骨傷科;
【分類號(hào)】：R687.3

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本文編號(hào)：2351352