外固定器治疗儿童胫骨慢性骨髓炎后骨缺损和肢体短缩

Experience of segment bone transport with the external fixator

[目的]探讨运用外固定器行骨段转移术治疗儿童胫骨慢性骨髓炎造成的骨缺损和肢体短缩的疗效及经验,为临床合理选择治疗方法提供依据。[方法]回顾性研究1994年1月～2010年1月采用外固定器治疗的26例儿童胫骨慢性骨髓炎造成的骨缺损和肢体短缩行骨段转移术。男15例,女11例,年龄8～17岁,平均11.6岁,术前患肢平均骨缺损长度4.8 cm,肢体短缩差值平均5.3 cm。[结果]全部病人均获随访。术后随访平均116个月,平均外固定指数48.0 d/cm。延长范围5.8～15.1 cm(平均10.3 cm),骨不连接愈合时间平均6.6个月(4～13个月)。骨愈合率100%,所有患者肢体长度差异得到纠正。[结论]骨外固定器行骨段转移术是治疗儿童伴有肢体短缩的胫骨大段骨缺损的有效方法。

[Objective]To discuss the experience of segment bone transport with the external fixator for tibial nonunions with bone defect due to chronic osteomyelitis. [ Method] Between January 1994 to January 2010,26 child patients（ mean age, 11.6 years） with tibial nonunion caused by chronic osteomyelitis were treated by segment bone transport. There were 15 males and 11 females ,aged from 8 to 17 years. The mean length of the bone defect was 4.8 em and the mean limb-length discrepancy was 5.3 em. [ Result] Twenty-six patients were followed up for a mean of 116 months. The average external fixation index was 48.0 d/cm. The extent of lengthening ranged from 5.8 to 15.1 era（ average, 10.3 era）. Healing-rate was 100%. All the patients resumed the normal length of limbs. E Conclusion ] Segment bone transport with external fixator is an effective treatment for massive postosteomyelitis bone defects and leg shortening.