Department of Orthopaedics, No. 958 Hospital of Army, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Z Orthop Unfall. 2023 Jun;161(3):311-317. doi: 10.1055/a-1545-5363. Epub 2021 Sep 8.
This study was designed to observe the medium-term efficacy of an induced membrane technique combined with a locking compression plate as an external fixator for the treatment of tibia infected bone defects.
Patients with a tibial infection were admitted to our department between January 2013 and November 2014. All patients were treated with the induced membrane technique. In the first stage, polymethyl methacrylate (PMMA) cement was implanted in the defects after debridement and then fixed with a locking compression plate (LCP) as an external fixator. In the second stage, bone grafts were implanted to rebuild the defects. The external plates were replaced with nails in 57 patients (internal group), and the remaining 30 patients were not exchanged with fixation (external group). The infection control rate, bone union rate, and complications of the two groups were compared.
Eighty-seven patients were enrolled in this study, and all patients had a minimum follow-up of 5 years (average 62.8 months) after grafting. Eighty-three patients (95.4%) achieved bone union, and the average union time was 6.77 months. Five patients (5.7%) experienced recurrence of infection. Complications included pin tract infection, fixation loosening, deformity connection, and limitation of joint range of motion (ROM). No significant differences in the infection control rate or bone defect union rate were noted between the two groups. The overall rate of complications in the external group was 50%, which was greater than that noted in the internal group (21.1%).
Locking compression plates are external fixators with smaller sizes that are easier to operate than conventional annular fixators or assembled external fixators. The use of locking compression plates in combination with the induced membrane technique in the treatment of tibia infected bone defects can achieve good clinical efficacy after medium-term follow-up.
本研究旨在观察诱导膜技术联合锁定加压接骨板（LCP）外固定器治疗胫骨感染性骨缺损的中期疗效。
2013 年 1 月至 2014 年 11 月，本科室收治胫骨感染患者。所有患者均采用诱导膜技术治疗。一期清创后，在缺损处植入聚甲基丙烯酸甲酯（PMMA）水泥，然后用 LCP 固定作为外固定器。二期行植骨重建缺损。57 例患者（内固定组）更换为接骨钉，其余 30 例患者未更换固定（外固定组）。比较两组患者的感染控制率、骨愈合率及并发症。
本研究共纳入 87 例患者，所有患者植骨后均至少随访 5 年（平均 62.8 个月）。83 例（95.4%）患者达到骨性愈合，平均愈合时间为 6.77 个月。5 例（5.7%）患者出现感染复发。并发症包括钉道感染、固定松动、畸形连接和关节活动度（ROM）受限。两组患者的感染控制率和骨缺损愈合率无显著差异。外固定组并发症总发生率为 50%，高于内固定组（21.1%）。
与传统环形固定器或组合式外固定器相比，锁定加压接骨板作为外固定器尺寸较小，操作更简单。在胫骨感染性骨缺损的治疗中，采用锁定加压接骨板联合诱导膜技术可获得良好的中期临床疗效。
