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分期关节融合术结合 Masquelet 技术治疗伴有关节破坏的指骨骨髓炎:两例报告。

Staged arthrodesis using the Masquelet technique for osteomyelitis of the finger with articular destruction: a report of two cases.

机构信息

Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, 501-1194, Japan.

Department of Orthopaedic Surgery, Kizawa Memorial Hospital, Gifu, Japan.

出版信息

Arch Orthop Trauma Surg. 2019 Jul;139(7):1025-1031. doi: 10.1007/s00402-019-03197-5. Epub 2019 May 15.

Abstract

Osteitis of the fingers is a serious infection that needs early diagnosis and appropriate surgical debridement and antibiotic treatment of the infected bone. If the effects of treatments are insufficient, long-term antibiotic treatment and repeated operations could be required. In worst cases, some patients may have to undergo amputation. Recently, the usefulness of the Masquelet technique in extensive traumatic bone defects has been reported. We herein describe two cases of immunocompromised patients with purulent osteitis involving joint destruction of the finger treated by two-stage arthrodesis using the Masquelet technique. They obtained good infection control and better function of the finger than before the operation. Moreover, there was no recurrence of the infection. The Masquelet technique could be an alternative technique for osteitis with high risk of amputation.

摘要

手指骨髓炎是一种严重的感染,需要早期诊断和适当的手术清创以及感染骨的抗生素治疗。如果治疗效果不佳,可能需要长期的抗生素治疗和反复手术。在最坏的情况下,一些患者可能需要截肢。最近,Masquelet 技术在广泛创伤性骨缺损中的应用价值已有报道。我们在此描述了两例免疫功能低下的化脓性骨髓炎患者,这些患者的手指关节破坏,采用 Masquelet 技术进行了两阶段关节融合术。他们获得了良好的感染控制和比手术前更好的手指功能。此外,没有感染复发。Masquelet 技术可能是一种有高截肢风险的骨髓炎的替代技术。

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