扩髓-冲洗-抽吸技术治疗骨缺损和髓腔感染的研究进展

Research progress in reamer-irrigator-aspirator technique in the treatment of bone defects and intramedullary canal infection

治疗各种原因导致的大段骨缺损、骨不愈合时需要植骨,取自体髂骨一直被认为是骨移植治疗的"金标准",但是常常导致供区术后疼痛、麻木等并发症或取骨量不足等问题。扩髓-冲洗-抽吸(RIA)技术使供区并发症减少,最多可收集90 ml自体骨,可用于治疗更大范围的骨缺损,且还可用于髓腔感染病灶的清除,以及髓腔残存骨水泥的清理等。笔者就RIA装置的构造、RIA技术的操作过程、RIA技术的临床应用及并发症等的研究进展进行综述,为治疗骨缺损和髓腔感染提供借鉴。

Treatment of large bone defects and nonunion induced by various causes requires bone graft,and autologous iliac bone graft has always been considered as the gold standard for the treatment of bone transplantation.However,there exist problems such as postoperative pain and numbness in the donor area or insufficient bone taking.The application of reamer-irrigator-aspirator(RIA)technique can reduce complications in the donor area and collect a maximum of 90 ml of autologous bone to treat large bone defects.In addition,it can also be used to remove the infected lesion and residual bone cement in the medullary cavity.The authors review the instrument structure,operation process,clinical application and complications of RIA technique,so as to provide a reference in the treatment of bone defects and intramedullary canal infection.