一期植骨外固定治疗医源性骨感染

Treatment of iatrogenic osseous infection using bone grfting and external fixation at the same setting

目的 探讨闭合骨折内固定术后骨感染的治疗原则和方法。方法 对 2 5例闭合性骨折术后骨感染的病例 ,在彻底清除病灶 ,摘除死骨的基础上 ,一期植骨 ,依软组织缺损情况行肌瓣或肌皮瓣闭合创面。外固定器加压固定 ,持续冲洗—负压引流。结果 全部病例伤口一期愈合。术后 3～ 6个月 ,平均 4 5个月达到骨性愈合 ,无一例感染复发。结论 采用一期植骨的综合治疗措施 ,简化和缩短了治疗过程 ,改变了分期治疗骨髓炎的传统观念 。

Objective To investigate the principles and methods of the treatment of close fractures complicated with infection after internal fixation.Methods 25 patients of close fractures with bone infection after internal fixation operation were reviewed.After complete debridement and sequestrectomy,bone gfafting was done at th esame setting.According to condition of soft tissue defects,muscular or musclo cutaneous flaps were used to close the wound.Then immobilization was done with external fixators apparatus followed by contious irrigation under negative pressure.[HT5”H]Results [HT5”SS]All the cases had primary healing of the wound and bone union within 3 to 6 months (mean 4.5 months).There was no relapsed.[HT5”H]Conclusion [HT5”SS]The combined methods of debridement and bone grafting at the same setting simplified and shortened the course of treatment of iatrogenic bone infection.