Ren Peng, Ma Chuang
Department of Orthopedics, the First Affiliated Hospital to Xinjiang Medical University, Urumuqi Xinjiang, 830054, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Jul 15;34(7):862-868. doi: 10.7507/1002-1892.201912034.
To study the effectiveness of trifocal bone transport by using monolateral rail system in the treatment of bone defects caused by post-traumatic tibial osteomyelitis.
The clinical data of 28 patients with tibial defects caused by post-traumatic osteomyelitis treated with trifocal bone transport technique by using monolateral rail system between January 2012 and June 2017 were retrospectively analyzed. There were 26 males and 2 females, aged 22-59 years (mean, 41.3 years). The causes of injury included 13 cases of traffic accident injury, 9 cases of falling from height, 4 cases of heavy object injury, and 2 cases of crushing injury. The disease duration was 4.5-17.0 months (mean, 7.1 months). The length of bone defect was 6.5-16.8 cm (mean, 10.3 cm). And the range of soft tissue defect ranged from 3.5 cm×2.0 cm to 18.0 cm×11.0 cm. The bone transporting time, external fixation time, duration of regenerate consolidation, and external fixation index were recorded, and the complications were observed. At last follow-up, the bone and functional results were evaluated according to the criteria given by Association for the Study and Application of the Method of the Ilizarov (ASAMI).
All patients were successfully followed up after removing the external fixator with an average of 35 months (range, 24-65 months). The bone transporting time was 41-136 days (mean, 60.2 days), the external fixation time was 7.5-20.0 months (mean, 13.4 months), the external fixation index was 1.1-1.9 months/cm (mean, 1.4 months/cm), the duration of regenerate consolidation was 6.0-16.5 months (mean, 10.5 months). Pin tract infection occurred in 12 cases, delayed union on docking site was occurred in 9 cases, axial deviation was observed in 2 cases, poor regenerate consolidation was presented in 1 case, and refracture on docking site after fixator removal was occurred in 1 case. There was no recurrence of infection, amputation, vascular and neurologic complications, and osteofascial compartment syndrome. At last follow-up, according to ASAMI criterion, the bone healing results were excellent in 17 cases, good in 7 cases, and fair in 4 cases, with an excellent and good rate of 85.7%; the functional results were excellent in 15 cases, good in 10 cases, and fair in 3 cases, with an excellent and good rate of 89.3%.
Trifocal bone transport by using monolateral rail system is an effective method in the treatment of bone defect caused by post-traumatic osteomyelitis which can reduce bone transport time, external fixation time, and complications.
探讨采用单边轨道系统的三焦点骨搬运技术治疗创伤后胫骨骨髓炎所致骨缺损的有效性。
回顾性分析2012年1月至2017年6月采用单边轨道系统的三焦点骨搬运技术治疗创伤后骨髓炎所致胫骨缺损的28例患者的临床资料。其中男性26例，女性2例，年龄22 - 59岁（平均41.3岁）。受伤原因包括交通事故伤13例、高处坠落伤9例、重物砸伤4例、挤压伤2例。病程4.5 - 17.0个月（平均7.1个月）。骨缺损长度6.5 - 16.8 cm（平均10.3 cm）。软组织缺损范围为3.5 cm×2.0 cm至18.0 cm×11.0 cm。记录骨搬运时间、外固定时间、再生骨愈合时间及外固定指数，并观察并发症。末次随访时，根据Ilizarov方法研究与应用协会（ASAMI）给出的标准评估骨和功能结果。
所有患者拆除外固定架后均获成功随访，平均随访35个月（范围24 - 65个月）。骨搬运时间为41 - 136天（平均60.2天），外固定时间为7.5 - 20.0个月（平均13.4个月），外固定指数为1.1 - 1.9个月/cm（平均1.4个月/cm），再生骨愈合时间为6.0 - 16.5个月（平均10.5个月）。发生针道感染12例，对接部位延迟愈合9例，出现轴向偏移2例,再生骨愈合不佳1例，拆除固定架后对接部位再骨折1例。无感染复发、截肢、血管及神经并发症和骨筋膜室综合征发生。末次随访时，根据ASAMI标准，骨愈合结果优17例，良7例，可4例，优良率为85.7%；功能结果优15例，良10例，可3例，优良率为89.3%。
采用单边轨道系统的三焦点骨搬运技术是治疗创伤后骨髓炎所致骨缺损的有效方法，可缩短骨搬运时间、外固定时间并减少并发症。
