Yin P, Zhang Q, Mao Z, Li T, Zhang L, Tang P
Acta Orthop Belg. 2014 Sep;80(3):426-35.
This study was designed to evaluate the effectiveness of the treatment of infected tibial nonunion by bone transport using the Ilizarov external fixator. We retrospectively reviewed 66 patients with infected tibial nonunion treated by bone transport using the Ilizarov external fixator. Our study included 62 males and 4 females with a mean of age 37.06 years. The average length of the bone defects after radical debridement was 6.27 cm (range 3-13 cm). The mean follow-up after removal of the apparatus was 25.91 months (18-46 months). 6 patients were lost to follow-up. All the patients achieved bone union and no recurrence of infection was observed. The mean external fixation index was 1.38 months/cm (range 1.15-1.58 months/cm). According to Association for the Study and Application of the Method of Ilizarov (ASAMI) classification, bone results were excellent in 44, good in 15, fair in 5 and poor in 2; functional results were excellent in 24, good in 26, fair in 10 and no poor.
Our study and the current evidence suggested that Ilizarov methods in the treatment of infected tibial nonunion acquired satisfied effects in bone results and functional results. Radical debridement is the key step to control bone infection.
本研究旨在评估使用伊利扎洛夫外固定器通过骨搬运治疗感染性胫骨骨不连的有效性。我们回顾性分析了66例使用伊利扎洛夫外固定器通过骨搬运治疗的感染性胫骨骨不连患者。我们的研究包括62例男性和4例女性，平均年龄37.06岁。彻底清创术后骨缺损的平均长度为6.27厘米（范围3 - 13厘米）。去除外固定器后的平均随访时间为25.91个月（18 - 46个月）。6例患者失访。所有患者均实现骨愈合，未观察到感染复发。平均外固定指数为1.38个月/厘米（范围1.15 - 1.58个月/厘米）。根据伊利扎洛夫方法研究与应用协会（ASAMI）分类，骨结果优44例，良15例，可5例，差2例；功能结果优24例，良26例，可10例，无差。
我们的研究及现有证据表明，伊利扎洛夫方法治疗感染性胫骨骨不连在骨结果和功能结果方面均取得了满意效果。彻底清创是控制骨感染的关键步骤。
