Chevalley F, Livio J J, Blanc C H
Service d'Orthopédie-Traumatologie, CHUV, Lausanne, Suisse.
Rev Chir Orthop Reparatrice Appar Mot. 1990;76(4):280-3.
The authors present the case of an open fracture of femur Cauchoix type II with an infection due to Escherichia coli, Clostridium perfringens, Enterococcus and Aspergillus fumigatus. After several sequestrectomies and five hyperbaric sessions, apyrexia was attained at the end of the third month, the femur having been stabilised with an external fixator. The 15 cm gap due to loss of bone substance, filled at each dressing with an antiseptic iodine based ointment, closed itself finishing as continuous bone five months after the accident, the granulation tissue having been recovered by thin skin grafts. A repeated fracture occurring forty-eight hours after the removal of the Hoffmann frame was treated by fitting an Ilizarov fixator arriving at consolidation in seven months. The authors examine different possibilities of accelerating osteogenesis and highlight the potential role of iodine ointment as inductive to osteogenesis stemming from a periosteal layer seemingly held in place.
作者介绍了一例考乔伊氏II型股骨开放性骨折病例，该病例因大肠杆菌、产气荚膜梭菌、肠球菌和烟曲霉感染。经过多次死骨切除术和五次高压氧治疗后，第三个月末体温恢复正常，股骨已通过外固定架实现稳定。由于骨质缺损造成的15厘米间隙，每次换药时均用含碘消毒软膏填充，事故发生五个月后间隙自行闭合，形成连续的骨组织，肉芽组织已通过薄皮移植修复。拆除霍夫曼支架48小时后发生再次骨折，通过安装伊利扎罗夫固定架进行治疗，七个月后实现骨愈合。作者研究了加速骨生成的不同可能性，并强调碘软膏作为一种似乎能促使骨膜层发挥诱导骨生成作用的物质所具有的潜在作用。
