摘要
客观:避免二阶段的 cancellus 骨头自体移植的劣势,我们调查了一个阶段的可行性为重建的紧密相联的接枝从长期的骨髓炎的清创术导致手足的骨头缺点。方法:在 1999 年 2 月和 2004 年 4 月之间,长期的骨髓炎的 35cases (8 个案例不属于工会) 经历了一个阶段在我们的医院里的清创术以后的紧密相联的接枝。结果:35 个案例被跟随在上面为 28months 的一个平均时期(范围, 13 ~ 55 个月) ,在哪个 32 个案例(91.43%) 没被发现感染,并且 3 个案例(8.57%) 是感染的证实的复发。四从骨头的 8 个案例不属于工会在 9 愈合了。5months 平均(范围, 3 ~ 12 个月) ,并且另一个案例也在外科以后由于感染复发 35 天在肠骨的 redebridementand 自体移植以后获得了联合。不属于工会发生在 3cases, 2 从谁与自体移植在第二等的操作以后愈合了。一个案例不属于工会并且感染复发的 2cases 拒绝了进一步的处理。结论:当时,感染拘捕的高率能被达到一个阶段紧密相联的接枝被用来重建在在手足的清创术以后的长期的骨髓炎的骨头缺点。因此,长期的骨髓炎不应该被认为是禁止徵候到一个阶段 allogeneic 骨头 grafting。然而, Renonuion 完成相对高的率,特别在部分骨头缺点的情况下。
Objective: To avoid disadvantages of two-stage cancellus bone autograft, we investigated the feasibility of one-stage allograft for reconstructing the bone defect resulting from debridement of chronic osteomyelitis in limbs. Methods: Between Feb. 1999 and Apr. 2004, 35 cases of chronic osteomyelitis (8 cases of nonunion ) underwent one-stage allograft after debridement in our hospital. Results: Thirty-five cases were followed up for an average period of 28 months ( range, 13 to 55 months), in which 32 cases (91.43%) were found no infection, and 3 cases (8.57%) were confirmed recurrence of infection. Four out of 8 cases of bone nonunion healed in 9.5 months on average ( range, 3 to 12 months), and another case also acquired union after redebridement and autograft of iliumdue to infection recurrence 35 days after surgery. Renonunion occurred in 3 cases, 2 out of whom healed after secondary operation with autograft. One case of renonunion and 2 cases of infection recurrence refused further treatment. Conclusions: A high rate of infection arrest can be attained when one-stage allograft is used to reconstruct the bone defect of chronic osteomyelitis after debridement in limbs. Therefore, chronic osteomyelitis should not be regarded as a contraindication to one-stage allogeneic bone grafting. Renonuion, however, achieves a relatively high rate, especially in cases of segmental bone defect.