Evard J, d'Aubigne R M
Rev Chir Orthop Reparatrice Appar Mot. 1978 Jan-Feb;64(1):45-58.
The authors describe their views of management of septic non-union in fractures of the femoral shaft. Since 1967 they have used the same procedures: 1. Surgical clearance of debris in the region of the fracture focus and from sinuses. This clearance must be complete but not too extensive. 2. Closure of the wound with suction drainage or continuous irrigation with antibiotics. 3. Immobilization of the fracture by external fixation. 4. Secondary cancellous bone grafting, in most cases by grafts placed on the medial aspect of the bone. Twenty-eight cases were treated in this way and 27 united. The results are analysed with special reference to residual sinuses, shortening, knee stiffness and functional rehabilitation.
作者描述了他们对股骨干骨折后感染性骨不连的治疗观点。自1967年以来,他们一直采用相同的治疗方法:1. 手术清除骨折病灶区域及窦道内的碎片。这种清除必须彻底,但不能范围过大。2. 用负压引流或抗生素持续冲洗的方式闭合伤口。3. 采用外固定使骨折部位固定。4. 二期松质骨移植,多数情况下将骨移植于骨的内侧。采用这种方法治疗了28例患者,其中27例实现了骨愈合。并特别参照残留窦道、肢体短缩、膝关节僵硬及功能康复情况对结果进行了分析。