Alemdar Celil, Azboy Ibrahim, Atiç Ramazan, Özkul Emin, Gem Mehmet, Kapukaya Ahmet
Acta Orthop Belg. 2015 Sep;81(3):523-9.
The aim of this study was to evaluate the outcomes of internal fixation with Non-Contact Plating (NCP) after deep infection caused by previous surgeries of the tibia or femur fractures. The study included 15 patients (4 female and 11 male). The mean age patients was 36.6 years (range, 21-64 years). There were 6 femur and 9 tibia fractures. The mean follow-up period was 25.7 months (range, 15-45 months). The study comprised 11 open and 4 closed fractures. External fixator was used in 3, plate in 4, and intramedullary nail in 8 patients for index surgery. Deep infection was diagnosed via clinical findings, laboratory parameters, and microbiological evaulation. Deep infection was diagnosed within a mean period of 5.5 weeks (range, 2-10 weeks). The infecting organism was methicillin-resistant staphylococcus aureus (MRSA) in 5, methicillin-sensitive staphylococcus aureus (MSSA) in 6, pseudomonas auroginosa in 2, and enterobacteriacea in 2 patients. Union achieved in all patients. Mean time to union was 17 (range, 11-38) weeks. Delayed union was observed in 3 patients who required additional surgeries. Of these one patient developed osteomyelitis. The NCP is an effective alternative method in the treatment of deep infection encountered after internal or external fixation for the tibia, or femur fractures.
本研究的目的是评估在胫骨或股骨骨折既往手术引起深部感染后采用非接触钢板（NCP）内固定的效果。该研究纳入了15例患者（4例女性和11例男性）。患者的平均年龄为36.6岁（范围为21 - 64岁）。有6例股骨骨折和9例胫骨骨折。平均随访期为25.7个月（范围为15 - 45个月）。该研究包括11例开放性骨折和4例闭合性骨折。初次手术时，3例患者使用了外固定架，4例患者使用了钢板，8例患者使用了髓内钉。通过临床检查结果、实验室参数和微生物学评估诊断深部感染。深部感染的诊断平均在5.5周（范围为2 - 10周）内。感染病原体为耐甲氧西林金黄色葡萄球菌（MRSA）的有5例，甲氧西林敏感金黄色葡萄球菌（MSSA）的有6例，铜绿假单胞菌的有2例，肠杆菌科的有2例。所有患者均实现了骨折愈合。平均愈合时间为17周（范围为11 - 38周）。3例患者出现延迟愈合，其中1例发生了骨髓炎。NCP是治疗胫骨或股骨骨折内固定或外固定后出现的深部感染的一种有效替代方法。
