Salem Khaled Hamed, Kinzl Lothar, Schmelz Andreas
Department of Trauma, Hand, and Reconstructive Surgery, University of Ulm, Germany.
J Knee Surg. 2006 Apr;19(2):99-104. doi: 10.1055/s-0030-1248087.
Deep infection is one of the most devastating complications after knee fractures. It may be related to the initial fracture status or, more commonly, the surgical intervention. From 1991 to 2003, 12 patients underwent knee fusion to treat resistant infection after complex knee fractures or arthrodesis fractures using the Ilizarov method and frame. There were 9 men and 3 women (mean age, 39.7 years). Two-thirds of the patients had long-standing infection and 5 patients had undergone earlier attempts at knee arthrodesis. Correction of concurrent malalignment was achieved in 2 patients. Bone transport using the same arthrodesis frame was necessary in 2 patients to overcome large bony defects. Solid fusion was achieved in all patients by the end of treatment. The average duration of external fixation was 22 weeks (range: 11-44 weeks). No patients required secondary bone grafting to achieve union. Complications occurred in 6 (50%) patients. The most common problem seen was pin tract infection, but only 2 patients required surgical intervention for its treatment. The study emphasizes the clinical success of the Ilizarov method in knee arthrodesis after infected fractures.
深部感染是膝关节骨折后最严重的并发症之一。它可能与初始骨折状态有关,或者更常见的是与手术干预有关。1991年至2003年期间,12例患者采用伊里扎洛夫方法和器械,通过膝关节融合术治疗复杂膝关节骨折或关节融合性骨折后的顽固性感染。其中男性9例,女性3例(平均年龄39.7岁)。三分之二的患者存在长期感染,5例患者曾早期尝试进行膝关节融合术。2例患者实现了同时存在的畸形矫正。2例患者需要使用相同的关节融合器械进行骨搬运,以克服大的骨缺损。所有患者在治疗结束时均实现了牢固融合。外固定的平均持续时间为22周(范围:11 - 44周)。没有患者需要二次植骨来实现骨愈合。6例(50%)患者出现了并发症。最常见的问题是针道感染,但只有2例患者需要手术干预来治疗。该研究强调了伊里扎洛夫方法在感染性骨折后膝关节融合术中的临床成功。