Masquelet技术联合自体腓骨及髂骨移植治疗慢性骨髓炎伴骨缺损疗效分析

Clinical Efficacy of Masquelet Technique Combined with Autologous Fibular and Iliac Bone Graft in Treating Chronic Osteomyelitis Complicated with Bone Defect

目的研究探讨Masquelet技术联合自体腓骨及髂骨移植治疗慢性骨髓炎伴骨缺损的临床效果。方法给予2018年1月至2020年5月玉林市中西医结合骨科医院收治的15例慢性骨髓炎伴骨缺损患者应用Masquelet技术联合自体腓骨及髂骨移植治疗,观察术后切口、骨折与骨缺损愈合情况以及肢体功能恢复情况。结果术后随访1~2年,15例患者术后切口均甲级愈合;除1例胫骨慢性骨髓炎伴骨缺损患者因过早拆除外固定支架再发骨折外,其余患者骨折部位均愈合,愈合时间为3.0~6.0个月,平均4.5个月。末次随访时,15例患者均能弃拐负重行走,骨缺损愈合等级为优9例、良4例、可2例,优良率为86.7%;肢体功能恢复等级为优10例、良3例、可2例,优良率为86.7%。结论Masquelet技术联合自体腓骨及髂骨移植治疗慢性骨髓炎伴骨缺损,可有效修复骨缺损,最大程度恢复肢体功能,效果确切,临床应用价值较高。

Objective To investigate the clinical efficacy of Masquelet technique combined with autologous fibular and iliac bone graft in the treatment of chronic osteomyelitis complicated with bone defect.Methods 15 patients with chronic osteomyelitis and bone defect,admitted to Yulin Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to May 2020,were treated with Masquelet technique combined with autologous fibular and iliac bone graft.The healing of incision,fracture and bone defect,and the recovery of limb function were observed.Results The 15 patients were followed up for 1 to 2 years and all the incisions of patients achieved level A healing.One case with tibial chronic osteomyelitis complicated with bone defect suffered secondary fracture due to early removal of external fixation scaffolds,and all the other patients realized fracture healing,and the healing time was 3.0-6.0 months,with an average of 4.5 months.During the last-time follow-up,all the 15 patients were able to walk without the assistance of crutches,and the bone defect healing condition was evaluated as excellent in 9 cases,good in 4 cases,and fair in 2 cases,with the excellent and good rate being 86.7%,and the limb function recovery condition was evaluated as excellent in 10 cases,good in 3 cases and fair in 2 cases,with the excellent and good rate being 86.7%.Conclusion Masquelet technique combined with autologous fibular and iliac bone graft,in the treatment of chronic osteomyelitis complicated with bone defect,can effectively repair bone defect,and restore limb functions to the greatest extent,and the clinical efficacy was definite.