Ilizarov技术治疗胫骨感染性骨缺损15例

Ilizarov Technique in Treatment of 15 Cases of Tibial Infected Bone Defect

目的探讨Ilizarov技术在治疗胫骨感染性骨缺损的临床疗效,分析该技术最佳适应症.方法对2013年1月至2017年1月收治的15例胫骨感染性骨缺损手术患者进行回顾性分析.骨缺损长度4~7 cm,平均5.6 cm.均行一期清创、Ilizarov外固定架固定、截骨、骨搬运.记录患肢术后愈合率、并发症及功能等情况,并采用Paley骨折愈合评分标准进行评价.结果所有患者均获11~42个月随访,平均28.4个月.术后定期行X线摄片检查评估骨愈合情况,愈合时间5~13个月,平均8.6个月.无胫骨感染复发.7例出现针道感染,2例延长过程中出现骨端对位不良.肢体长度恢复良好,邻近关节功能良好.Paley评分,优7例,良6例,优良率86.7%.结论采取Ilizarov技术治疗胫骨感染性骨缺损可获得较好的疗效,该技术较适于胫骨大段感染性骨缺损、骨髓炎及合并软组织缺损的患者.

Objective To explore the clinical efficacy of Ilizarov technique in treatment of Tibial infected bone defect,and analyze the best indications.Methods We retrospectively analysed the data of15cases of tibial infected bone defect,from January2013to January2017.The length of bone defect ranged from4-7cm,with an average of5.6cm.All patients were treated by debridement,Ilizarov external fixation,immediately osteotomy,bone transport.Then we recorded the postoperative healing rate,complications and function,and evaluated by Paley criteria.Results Their follow-up periods ranged from11to42months(mean,28.4months).Postoperative X-ray radiography examination was taken Regularly to evaluate bone healing process,healing time5~13months,the average8.6months.There was no recurrence of tibia infection,skin dragging pain was found in7cases,malposition in2cases.The Limb length recovered well,and adjacent joints,function was good.According to Paley criteria for management of infectious tibial defect,7cases were rated as excellent and6as good,the excellent rates was86.7%.Conclusion For treatment of tibial large infected bone defect associated with soft tissue defects,application of Ilizarov Technique can be effective.