抗感染活性骨治疗感染性胫骨骨不连的临床研究

A Clinical Study on the ARBX in the Treatment of Infected Tibial Nonunion

目的:观察抗感染活性骨(ARBX)治疗感染性胫骨骨不连的临床效果。方法:回顾性分析我院自2008年1月-2015年1月收治并系统随访应用抗感染骨治疗的36例创伤后感染性骨不连病例,给予原内固定取出或外架拆除,病灶清除,去除硬化骨及死骨,髓腔再通,抗感染活性骨植骨,外架或钢板重新固定,统计患者病程时间,伤口愈合时间,患者院前手术次数,滴注引流时间及抗生素应用疗程,骨性愈合时间,内、外固定物拆除时间以及功能恢复情况,并总结治疗疗效。结果:平均随访2.4年(1年2月-4年10月),骨不连彻底治愈30例,4例患者感染控制,半皮质愈合,2例感染复发,骨不连未愈合。结论:1抗感染活性骨是治疗感染性骨不连的一种有效的植骨材料,具有控制感染,促进骨折愈合的作用;2彻底清除坏死,失活组织是控制感染,促进感染性骨不连愈合的关键;3清理断端,断端骨髓腔再通可促进成骨,促进骨折愈合。

Objective： To observe the clinical effect of ARBX in the treatment of infected tibial nonunion.Methods： A retrospective analysis was performed on 36 cases of patients with infected tibial nonunion in our hospital from January 2008 to January 2015,the patients were given the fixed outer frame remove or dismantle the original,debridement,removal of sclerotic bone and dead bone,marrow recanalization,anti-infective activity of bone graft,the outer frame reseat,statistical time course of disease,wound healing time,the number of patients before surgery hospital,drip draining time and antibiotics treatment,bone healing time,inside and outside fixtures dismantling time and functional recovery,treatment efficacy summary.Results： The average follow-up of 2.4 years（1 February--4 October）,nonunion completely cured 30 cases,4 cases of patients with infection control,half leather healing,two cases of recurrent infection,nonunion did not heal Conclusion The average follow-up of 2.4 years（1 February--4 October）,nonunion completely cured 30 cases,4cases of patients with infection control,half leather healing,two cases of recurrent infection,nonunion did not heal.Conclusions： 1The anti-infective activity of bone graft material is an effective treatment of infected nonunion,with the control of infection,promote fracture healing; 2The elimination of necrotic,devitalized tissue to control infection,promote bone infection key nonunion healing; 3Cleanup stump,stump marrow cavity recanalization can promote bone formation,promote healing.