摘要
目的:总结应用Ilizarov技术加压延长方法治疗感染性骨不连的经验。方法:应用Ilizarov技术加压延长方法治疗长骨干骨不连缺损20例,在骨折端穿入骨圆针,在截骨处与骨纵轴垂直穿入圆形针锯,安装双轨外固定延长器。术后7天始以1.0 mm速度每天延长截骨端至骨缺损长度后停止。延长骨段骨性愈合后拆除延长器。结果:采用Ilizarov支架固定治疗后骨不连0.7~1.2 a愈合,愈合率100%。全部患者患肢可不扶拐负重行走,关节活动明显优于术前。结论:Ilizarov支架治疗长骨干感染性骨不连具有不加重骨折端软组织和骨组织的血运的损伤;避免了内置物所导致的二重感染;便于调整,有助于关节功能的恢复;缓慢牵伸产生的一定张力,可刺激骨组织的再生和活跃生长,达到骨段延长目的;加压使缺损两端骨面紧密对合,在干骺端骨延长过程中,有利于缺损骨端的愈合等优点。
Objective:To summarize the experience of Ilizarov technology pressure extending method applicated in infected nonunion.Methods:Application of Ilizarov pressure extending method in treatment of 20 cases with long bone nonunion defect,penetration bone round needle in the end of fracture,penetrated circular needle saws vertically at the osteotomy and bone,installed dual external distraction device.From the seventh day after operation,osteotomy began to prolonge with a rate of 1.0 mm every day until reach the length of bone defect.Removed the extender after bone healing of the lengthening bone.Results:After the treatment of Ilizarov bracket fixation,bone nonunion 0.7~1.2a healed,and the healing rate was 100%.All cases limb can weight-bearing walking without crutches,joint activities were excellent than preoperation.Conclusion:The Ilizarov stent in the treatment of infected nonunion of long bone did not aggravate the blood circulation injury of fracture tip soft tissue and bone tissue.It can avoid double infection caused by implants.It is easy to adjust and contribute to the recovery of joint function.It also can slow the tension produced by drawing,and stimulate the regeneration of bone tissue and active it growth,so it can achieve the goal of bone lengthening.Pressure can make the bone surface of both defect ends together closely.In metaphyseal bone lengthening process,it is beneficial to bone defect healing.
