资源有限情况下,应用诱导膜技术重建创伤性胫骨缺损的挑战:一项队列研究。
Challenges of the induced-membrane technique in the reconstruction of traumatic tibial defect with limited resources : a cohort study.
出版信息
Acta Orthop Belg. 2020 Dec;86(4):606-613.
This study sought foremost to evaluate the outcomes of applying the induced membrane technique (IMT) for tibia reconstruction within the context of a sub-Saharan Africa trauma center. Second, this study aimed to elucidate the conditions of IMT usage in a limited-resource setting. A retrospective study was performed among patients treated via IMT for posttraumatic tibial bone defects who had follow-up data available for at least 12 months. Eleven patients with a mean age of 36 years were included. All presented with an infected multi-tissue defect. The mean length of the tibia defect was 4.4 cm and the mean area of the soft-tissue loss was 32 cm . Pedicled flap coverage was required in all cases. At the mean follow-up time of 15 months bone union was achieved in nine of 11 cases, after additional inter-tibiofibular grafting was performed in four cases. Infection recurrence was noted in five of 11 cases. Most patients presented medium-quality soft-tissue coverage and suboptimal function. IMT may represent a valuable option for tibia reconstruction with limited surgical resources in cases where appropriate infection control and stable soft-tissue coverage can be ensured.
本研究主要评估了诱导膜技术(IMT)在撒哈拉以南非洲创伤中心用于胫骨重建的效果。其次,本研究旨在阐明在资源有限的情况下使用 IMT 的条件。对至少随访 12 个月的因创伤导致胫骨骨缺损而接受 IMT 治疗的患者进行了回顾性研究。共纳入 11 例平均年龄为 36 岁的患者,所有患者均表现为感染性多组织缺损。胫骨缺损的平均长度为 4.4cm,软组织丢失的平均面积为 32cm 。所有病例均需带蒂皮瓣覆盖。在 11 例患者中的 9 例获得骨愈合,4 例患者进行了额外的胫腓骨间移植。11 例中有 5 例出现感染复发。大多数患者的软组织覆盖质量中等,功能不佳。在可以确保适当的感染控制和稳定的软组织覆盖的情况下,IMT 可能是一种具有有限手术资源的胫骨重建的有价值的选择。