Unidad de Patología Séptica y Reconstructiva del Aparato Locomotor, Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario Virgen de La Arrixaca, Murcia, Spain.
Grupo de Estudio de Enfermedades Infecciosas, Universidad de Murcia, Murcia, Spain.
Eur J Orthop Surg Traumatol. 2021 Oct;31(7):1375-1386. doi: 10.1007/s00590-020-02862-5. Epub 2021 Feb 8.
Although bone transport is generally accepted as the gold standard for the treatment of segmental septic bone defects, some aspects of its practical application are still open to debate. We present our results in this field and compare them with the series published so far.
We reviewed all our patients (2010-2018) that underwent a bone transport procedure in the lower limb due to a septic bone defect. We calculated the bone healing index (BHI), the external fixation index (EFI), the rate of complications and the clinical results. We statistically compared our results with 63 publications with a similar scope.
Thirty-five patients (30 M/5F) with a mean age of 40 years and a mean follow-up of 45 months were included. Bone segment was 24 T/11F and mean defect was 8.4 cm (7.34 T/ 10.73F). Mean global BHI was 45.62 days/cm (48.16 T/40.09F). Mean EFI was 2.37 months/cm. Results were excellent in 9 patients, good in 23 and bad in 3. Bone graft was used in 60% of the cases.
The size of our series is similar to previously published ones, although the mean age of our patients is higher and they present a larger bone defect. BHI of our series is similar to that of other series, although EFI is significantly higher. The number of complications is also in line with the existing literature.
The use of a two-stage technique for managing segmental bone defects of septic origin in the lower extremity is a valid alternative. Our series shows results comparable to the current literature.
虽然骨搬运术通常被认为是治疗节段性感染性骨缺损的金标准，但其实践应用的某些方面仍存在争议。我们在此介绍我们在这一领域的结果，并将其与迄今为止发表的系列研究进行比较。
我们回顾了 2010 年至 2018 年间所有因感染性骨缺损而行下肢骨搬运术的患者。我们计算了骨愈合指数（BHI）、外固定指数（EFI）、并发症发生率和临床结果。我们将这些结果与具有相似范围的 63 篇文献进行了统计学比较。
共纳入 35 例患者（30 例男性/5 例女性），平均年龄为 40 岁，平均随访时间为 45 个月。骨段为 24 例胫骨/11 例股骨，平均缺损长度为 8.4cm（7.34 例胫骨/10.73 例股骨）。总体 BHI 平均值为 45.62 天/cm（48.16 例胫骨/40.09 例股骨）。EFI 平均值为 2.37 个月/cm。9 例患者的结果为优，23 例为良，3 例为差。60%的病例中使用了骨移植。
尽管我们患者的平均年龄更高，且存在更大的骨缺损，但我们的研究系列的规模与已发表的研究相似。我们的系列研究的 BHI 与其他系列相似，尽管 EFI 明显更高。并发症的数量也与现有文献相符。
在下肢感染性骨缺损的治疗中，采用两阶段技术是一种有效的替代方法。我们的研究系列结果与现有文献相当。
