Monsivais J J
Department of Orthopaedics, Texas Tech School of Medicine, El Paso, USA.
J South Orthop Assoc. 1996 Spring;5(1):30-6.
We report results and follow-up on a series of 34 patients who had chronic osteomyelitis resulting from complex open fractures. Treatment included debridement followed by cancellous bone grafting and simultaneous free flap transfer for coverage and revascularization. Thirty-one patients remained in the final study. For the 24 patients with lower extremity injuries, follow-up averaged 45.4 months (range, 10 to 84 months). There was a 4% recurrence rate of osteomyelitis (1 of 24 patients). Follow-up on the 7 patients with upper extremity injuries averaged 39.8 months (range, 22 to 60 months). There were no recurrences in this group. Serial debridement followed by simultaneous bone grafting and free flap transfer may be the most effective method available for the treatment of chronic osteomyelitis after grade III open fractures. This method produces the same results currently reported in the literature, but with one less operation.
我们报告了一系列34例因复杂开放性骨折导致慢性骨髓炎患者的治疗结果及随访情况。治疗方法包括清创术，随后进行松质骨移植，并同时进行游离皮瓣转移以覆盖创面和重建血运。最终有31例患者纳入研究。对于24例下肢损伤患者，随访时间平均为45.4个月（范围为10至84个月）。骨髓炎复发率为4%（24例患者中有1例）。7例上肢损伤患者的随访时间平均为39.8个月（范围为22至60个月）。该组无复发病例。连续清创术，随后同时进行骨移植和游离皮瓣转移，可能是治疗Ⅲ级开放性骨折后慢性骨髓炎最有效的方法。该方法产生的结果与目前文献报道的相同，但手术次数少一次。
