Department of Trauma and Microreconstructive Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, Xinjiang, China.
BMC Musculoskelet Disord. 2022 Feb 9;23(1):132. doi: 10.1186/s12891-022-05078-2.
The purpose of this study was to evaluate the outcomes of bifocal bone transport in the treatment of femoral bone defects caused by infections.
Clinical and radiographic data of patients with infected femoral nonunion treated by the bifocal bone transport at our hospital were analyzed retrospectively, from January 2008 to December 2019. Depending on the location of bone defects, the patients were divided into three groups (proximal, intermediate, and distal). The Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria was applied to assess the bone and functional outcomes. Postoperative complications of three groups were documented and compared.
Seventy-six cases of infected femoral bone defects (31 cases of proximal, 19 cases of intermediate, and 26 cases of distal) were managed by bifocal bone transport successfully with a mean follow-up time of 30.8 months (range, 23 to 41 months). There were 58 men (76.3%) and 18 women (23.6%), with a mean age of 38.8 years (range, 23 to 60 years). The bone union was received in 76 cases with a mean of 6.9 months (range, 5 to 8 months). Pin tract infection was observed in twenty-nine cases (38.1%), 7 cases (9.2%) of muscle contractures, 3 cases (7.9%) of joint stiffness, 13 cases (17.1%) of axial deviation, 2 cases (2.6%) of delayed union, one case (1.3%) of nonunion, and none (0%) of transport gap re-fracture. One patient (1.3%) was scheduled for knee arthroplasty when bone transport treatment ended.
Bone transport using an external rail fixator was a practical method to treat the femoral bone defects, since the satisfactory rate of bone union and limb function recovery. Complications of distal femoral bone transport were more severe than the proximal and intermedia, but the rate of complication was the least of the three groups. Soft-tissue-related complications were more likely to occur in the intermediate bone transport.
本研究旨在评估双焦骨搬运术治疗感染性股骨骨缺损的治疗效果。
回顾性分析 2008 年 1 月至 2019 年 12 月我院采用双焦骨搬运术治疗感染性股骨骨不连患者的临床和影像学资料。根据骨缺损的位置，将患者分为三组（近端、中间和远端）。采用 Association for the Study and Application of the Method of Ilizarov（ASAMI）标准评估骨与功能结局。记录三组术后并发症并进行比较。
76 例感染性股骨骨缺损患者（近端 31 例、中间 19 例、远端 26 例）成功接受双焦骨搬运术治疗，平均随访时间为 30.8 个月（2341 个月）。58 例为男性（76.3%），18 例为女性（23.6%），平均年龄 38.8 岁（2360 岁）。76 例患者骨愈合，平均时间为 6.9 个月（5~8 个月）。29 例（38.1%）发生针道感染，7 例（9.2%）发生肌肉挛缩，3 例（7.9%）发生关节僵硬，13 例（17.1%）发生轴向偏差，2 例（2.6%）发生延迟愈合，1 例（1.3%）发生骨不连，无（0%）发生搬运间隙再骨折。当骨搬运治疗结束时，1 例（1.3%）患者计划行膝关节置换术。
采用外固定架骨搬运术是治疗股骨骨缺损的一种实用方法，因为其具有较高的骨愈合率和肢体功能恢复率。与近端和中间骨段相比，远端股骨骨段搬运术的并发症更为严重，但三组中并发症发生率最低。中间骨段搬运术更易发生软组织相关并发症。
