Gunawan Bambang, Wijaya Mohammad Triadi, Pohan Muhammad Alvin Shiddieqy
Department of Orthopaedics and Traumatology, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Resident of Orthopaedic Surgery, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Ann Med Surg (Lond). 2019 Nov 5;48:109-114. doi: 10.1016/j.amsu.2019.10.028. eCollection 2019 Dec.
Despite advances in treatment, chronic osteomyelitis and infected nonunion after trauma remain a challenge to the orthopaedic field. The Papineau technique, firstly described in 1973, is an alternative to treat such conditions in hospitals where microsurgery is not available, making closure of defect using flap is not feasible. We described our experience in treating patients with chronic osteomyelitis and infected non-union of tibial fractures using the Papineau technique.
We reviewed the records of patients with severe open tibial fractures with bone defects who were treated using the Papineau technique at Cipto Mangunkusumo Hospital, Jakarta, Indonesia during the period of January 2017 to August 2019. Those with diabetes mellitus, severe liver disease, or malignancies were excluded. All surgical procedures were performed by one senior orthopedic surgeon.
A total of four subjects were enrolled in this study. All subjects were male, with a mean age of 29 ± 6.16 years of age. The mean time to granulation tissue was 21.5 ± 1.29 days, and the mean time to union was 6 ± 0 months. There were no complications.
The Papineau technique may provide successful eradication of infection, reconstruction of bone defect, and soft-tissue closure. In addition, this technique is feasible and safe, and it could be performed in small healthcare centres.
尽管治疗方法有所进步，但慢性骨髓炎和创伤后感染性骨不连仍是骨科领域面临的挑战。1973年首次描述的帕皮诺技术，是在无法进行显微外科手术、无法使用皮瓣闭合缺损的医院中治疗此类病症的一种替代方法。我们描述了使用帕皮诺技术治疗慢性骨髓炎和胫骨骨折感染性骨不连患者的经验。
我们回顾了2017年1月至2019年8月期间在印度尼西亚雅加达西托·曼古库苏莫医院接受帕皮诺技术治疗的严重开放性胫骨骨折合并骨缺损患者的记录。排除患有糖尿病、严重肝病或恶性肿瘤的患者。所有手术均由一名资深骨科医生进行。
本研究共纳入4名受试者。所有受试者均为男性，平均年龄为29±6.16岁。肉芽组织形成的平均时间为21.5±1.29天，骨折愈合的平均时间为6±0个月。无并发症发生。
帕皮诺技术可能成功根除感染、重建骨缺损并闭合软组织。此外，该技术可行且安全，可在小型医疗中心进行。
