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应用伊利扎罗夫外固定架闭合软组织缺损:病例系列。

Soft tissue defect closure using an Ilizarov frame: a case series.

出版信息

Acta Orthop Belg. 2024 Jun;90(2):287-292. doi: 10.52628/90.2.10777.

Abstract

The Ilizarov technique is a well-known procedure for limb deformity corrections. However, in the present study, the purpose was to examine the potential of wound closure by means of an Ilizarov frame. Two main cases are presented, a further seven were retrospectively reviewed. The first case experienced a chronic wound at the tibial tuberosity. A fistula was excised followed by antibiotic therapy, however, dehiscence at the wound occurred for which an Ilizarov procedure was used. After two weeks the frame was removed and the wound was closed. The second patient underwent osteosynthesis of a tibia and fibula fracture but was complicated by infection. An Ilizarov device was applied for bone healing as well as the skin defect. Nine patients were included in total. Four of them attained enough skin length via the Ilizarov procedure for secondary closure. Three had the frame removed before having full wound covering and needed further granulation of the wound. Finally, two more patients underwent graft reconstruction. Three patients suffered from infectious complications. The gold standard in soft tissue closure remains skin or flap reconstruction, however, this is not advisable in poor overall health and decreased local vascularity. If an Ilizarov frame is present for bone reconstruction, it can simultaneously be used for skin closure. The results shown in the current study indicate that a satisfactory outcome can be achieved.

摘要

伊利扎罗夫技术是一种众所周知的肢体畸形矫正方法。然而,在本研究中,目的是研究伊利扎罗夫架闭合伤口的潜力。介绍了两个主要病例,并回顾性分析了另外七个病例。第一个病例在胫骨结节处有慢性伤口。切除瘘管后进行抗生素治疗,但伤口出现裂开,因此使用伊利扎罗夫技术。两周后拆除框架并闭合伤口。第二个患者行胫骨和腓骨骨折内固定术,但合并感染。为了骨愈合和皮肤缺损,应用了伊利扎罗夫装置。共纳入 9 例患者。其中 4 例通过伊利扎罗夫技术获得足够的皮肤长度,可进行二期缝合。3 例在完全覆盖伤口前拆除框架,需要进一步肉芽创面处理。最后,还有 2 例患者行植皮重建。3 例患者发生感染并发症。软组织闭合的金标准仍然是皮肤或皮瓣重建,但在整体健康状况不佳和局部血管减少的情况下不建议使用。如果存在用于骨重建的伊利扎罗夫架,它也可以同时用于皮肤闭合。本研究结果表明可以获得满意的效果。

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