Ⅰ期自体松质骨移植修复胫骨创伤后骨髓炎骨缺损的临床研究

Single stage treatment of tibial post-traumatic osteomyelitis bone defects with autologous cancellous bone grafting

目的探讨Ⅰ期自体松质骨治疗胫骨创伤后骨髓炎骨缺损的临床疗效。方法回顾性分析2010年1月至2012年9月收治的18例胫骨骨髓炎患者，包括11例感染性骨不连。彻底清创后Ⅰ期移植颗粒状自体松质骨，外置锁定钢板作为外固定支架。结果18例患者随访12-34个月，平均21个月。其中15例获得骨愈合；2例患者同时发生炎症复发和骨吸收；1例骨不连患者获得骨愈合但需要再次清创；2例患者发生钉道感染，其中1例同时发生骨吸收需要再次植骨。结论结合外固定支架，彻底清创后选择一些小节段的骨髓炎骨缺损患者行Ⅰ期自体松质骨移植治疗胫骨创伤后骨髓炎可以取得良好的临床效果。

Objective grafting To investigate the clinical efficiency in treatment of tibial post-traumatic osteomyelitis. Methods of single stage autologous cancellous bone Clinical data of 18 patients with tibial post-traumatic osteomyelitis, including 11 infected nonunion patients, in our center from January 2010 to September 2012 were collected and retrospectively analyzed. Autologous granulated cancellous bone was grafted after radical debridement, and a locking compression plate was employed as an external fixator to stabilize the bone. Results All 18 patients were follow up for a mean period of 21 months （ranging from 12 to 34 months）. Among them, 15 patients acquired bone union. Bone absorption and infection recurrence was observed in 2 patients. One patient with bone union needed another debridement to attain bone union. Pin track infection occurred in 2 patients and one of them needed another debridement and bone grafting. Conclusion In conjunction with thoroughly debridement and external fixator, single stage bone grafting can be used selec tively to treat those patients with smaller segmental tibial post-traumatic osteomyelitis defects, and sound clinical outcome will attained.