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跟骨切除术:在跟骨骨髓炎情况下避免大截肢——病例系列

Calcanectomy: avoiding major amputation in the presence of calcaneal osteomyelitis-A case series.

作者信息

Walsh Tom P, Yates Ben J

机构信息

Department of Trauma and Orthopaedics, Great Western Hospitals, NHS Foundation Trust, Great Western Hospital, Marlborough Road, Swindon, United Kingdom.

出版信息

Foot (Edinb). 2013 Dec;23(4):130-5. doi: 10.1016/j.foot.2013.09.002. Epub 2013 Oct 10.

Abstract

BACKGROUND

Calcaneal osteomyelitis is a surgical diagnosis that may be treated by local, resection or major amputation.

OBJECTIVE

To determine the effectiveness of calcanectomy for treating calcaneal osteomyelitis.

METHOD

We conducted a retrospective review of patients receiving calcanectomy between 1st April 2005 and 1st October 2011 for calcaneal osteomyelitis. We reviewed these cases to determine healing, rate, microbiological analysis, length of stay, limb salvage rate and survival rate.

RESULTS

There were 10 patients included in this review. There were 7 with diabetes and 3 without. Mean age of group with diabetes was 64 years, of this group 5/7 healed at a mean of 64 days. Mean length of stay for this group was 49.3 ± 39.4 days. 2 patients required a transtibial amputation. Mean age of group without diabetes was 77 years, healing at a mean of 19 days. Mean length of stay for this group was 14 ± 16.8 days and all survived over 3 years. Microbiological analysis of suspected osteomyelitic bone typically isolated >4 organisms.

CONCLUSIONS

Calcanectomy is a useful procedure for limb salvage. It may reduce morbidity rates for people with calcaneal osteomyelitis, those with diabetes can expect prolonged wound healing and longer length of stay.

摘要

背景

跟骨骨髓炎是一种外科诊断疾病,可通过局部治疗、切除或大截肢进行治疗。

目的

确定跟骨切除术治疗跟骨骨髓炎的有效性。

方法

我们对2005年4月1日至2011年10月1日期间因跟骨骨髓炎接受跟骨切除术的患者进行了回顾性研究。我们回顾这些病例以确定愈合情况、愈合率、微生物学分析、住院时间、保肢率和生存率。

结果

本研究纳入10例患者。其中7例患有糖尿病,3例未患糖尿病。糖尿病组的平均年龄为64岁,该组中5/7例平均在64天愈合。该组的平均住院时间为49.3±39.4天。2例患者需要进行经胫骨截肢。非糖尿病组的平均年龄为77岁,平均在19天愈合。该组的平均住院时间为14±16.8天,所有患者均存活超过3年。对疑似骨髓炎骨的微生物学分析通常分离出>4种微生物。

结论

跟骨切除术是一种有效的保肢手术。它可能降低跟骨骨髓炎患者的发病率,糖尿病患者的伤口愈合时间可能延长,住院时间也更长。

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