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[感染性胫骨骨不连——采用伊里扎洛夫方法治疗:多中心研究]

[Infected tibial nonunions--treatment by the Ilizarov method: multicentric study].

作者信息

Vukašinović Zoran, Spasovski Dušan, Vučetić Čedomir, Jovanović Vesna, Šešlija Igor, Živković Zorica

出版信息

Srp Arh Celok Lek. 2012 Jan-Feb;140(1-2):65-70. doi: 10.2298/sarh1202065v.

Abstract

INTRODUCTION

Associated bone tissue defect and infection, commonly result in non-healing, i.e., by the development of infected tibial nonunion.

OBJECTIVE

The aim of the paper was to present experiences acquired in the treatment of this problem by the application of the Ilizarov method.

METHODS

The analyses enrolled 16 patients diagnosed with infected tibial nonunion.The Ilizarov method was used in all the patients, of type bilocal synchronous compressive-distractive or bilocal alternating compressive-distractive. Bone and functional results were classified as excellent, good, fair and poor. Total follow-up period of the patients was 48.77 +/- 41.57 months on the average.

RESULTS

Fifteen (93.75%) cases of nonunions were successfully healed. According to the laboratory findings of inflammation, the same patients were also successfully treated for local infection. The inequality of the lower limbs was also resolved by new bone formation of average length of 5.75 +/- 3.29 cm. Poor result was verified in one (6.25%) patient only. The patient satisfaction was scored 3.73 +/- 1.33 and physician's satisfaction 4.33 +/- 1.11.

CONCLUSION

The Ilizarov method with bone transport, because of being capable to solve simultaneously a local infection and tibial malalignement, and by substituting bone and soft tissue defects, thus enabling healing of until then unhealed bone, has shown as the best method in the treatment of this complex problem, infected tibial nonunions.

摘要

引言

相关的骨组织缺损和感染通常会导致不愈合,即发生感染性胫骨骨不连。

目的

本文旨在介绍应用伊里扎洛夫方法治疗该问题所获得的经验。

方法

分析纳入了16例诊断为感染性胫骨骨不连的患者。所有患者均采用伊里扎洛夫方法,采用双局部同步加压-牵张或双局部交替加压-牵张类型。骨和功能结果分为优、良、中、差。患者的总随访期平均为48.77±41.57个月。

结果

15例(93.75%)骨不连成功愈合。根据炎症的实验室检查结果,同一批患者的局部感染也得到了成功治疗。下肢不等长也通过平均长度为5.75±3.29 cm的新骨形成得到解决。仅1例(6.25%)患者结果较差。患者满意度评分为3.73±1.33,医生满意度评分为4.33±1.11。

结论

带骨搬运的伊里扎洛夫方法能够同时解决局部感染和胫骨畸形问题,替代骨和软组织缺损,从而使此前未愈合的骨得以愈合,已显示出是治疗这种复杂问题——感染性胫骨骨不连的最佳方法。

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