Zalavras Charalampos G, Singh Anshuman, Patzakis Michael J
Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, LAC + USC Medical Center, Los Angeles, CA 90033, USA.
Clin Orthop Relat Res. 2007 Aug;461:31-4. doi: 10.1097/BLO.0b013e318098673f.
Intramedullary infection is a challenging problem and treatment usually includes removal of infected hardware and reaming of the medullary canal. We describe a new technique for canal débridement and evaluate its infection control rate in treating osteomyelitis of the tibia and femur. We retrospectively reviewed 11 patients with posttraumatic osteomyelitis of the tibia (n = 8) or femur (n = 3). Surgery included débridement, implant removal, and reaming of the medullary canal with a new device that allows reaming under simultaneous irrigation and aspiration. At a minimum followup time of 6 months (mean, 13 months; range, 6-23 months), we observed no recurrence of infection. Complications included one partial loss of a flap, one refracture of a tibia after an automobile versus pedestrian accident, and external fixator pin tract infections in one patient. These preliminary data suggest the new reaming device may be a useful adjunct for débriding intramedullary infections of the tibia and femur.
髓内感染是一个具有挑战性的问题，治疗通常包括取出感染的内固定器械以及扩髓。我们描述了一种新的髓腔清创技术，并评估其在治疗胫骨和股骨骨髓炎时的感染控制率。我们回顾性分析了11例创伤后胫骨（n = 8）或股骨（n = 3）骨髓炎患者。手术包括清创、取出内固定物，并用一种新装置进行髓腔扩髓，该装置可在同步冲洗和吸引的情况下进行扩髓。在至少6个月的随访时间（平均13个月；范围6 - 23个月）内，我们未观察到感染复发。并发症包括1例皮瓣部分坏死、1例在汽车与行人事故后胫骨再次骨折，以及1例患者出现外固定针道感染。这些初步数据表明，这种新的扩髓装置可能是清创胫骨和股骨髓内感染的一种有用辅助手段。
