DeSilva Gregory L, Fritzler Anthony, DeSilva Stephen P
Department of Orthopaedic Surgery, Wayne State University, Detroit, MI, USA.
Tech Hand Up Extrem Surg. 2007 Jun;11(2):163-7. doi: 10.1097/BTH.0b013e3180413e56.
Management of bone loss, particularly in the face of open or contaminated wounds, presents a reconstructive challenge. Polymethylmethacrylate impregnated with antibiotics has been used successfully in the treatment of infected total joint arthroplasty and open fractures. The cement delivers high-dose local concentrations of antibiotics while filling a space. This article presents our use of an antibiotic-impregnated cement spacer for bone loss in the forearm or hand in the face of open or infected wounds. The cement spacer fills a potential space, prevents the involution of the surrounding soft tissue, and delivers appropriate antibiotics. When the spacer is removed, the remaining sheath serves to hold and contain the cancellous bone graft.
骨缺损的处理，尤其是面对开放性或污染性伤口时，是一项重建难题。浸渍抗生素的聚甲基丙烯酸甲酯已成功用于治疗感染性全关节置换术和开放性骨折。骨水泥在填充间隙的同时能提供高剂量局部抗生素浓度。本文介绍了我们在面对开放性或感染性伤口时，使用抗生素浸渍骨水泥间隔物治疗前臂或手部骨缺损的情况。骨水泥间隔物填充潜在间隙，防止周围软组织内卷，并输送合适的抗生素。当取出间隔物时，剩余的鞘膜可用于容纳松质骨移植块。
