骨搬移治疗外伤性胫骨骨髓炎伴大段骨缺损的疗效观察

发布时间：2018-07-15 15:45

【摘要】：目的:观察外伤性胫骨骨髓炎后大段骨缺损行骨搬移治疗的疗效。方法:回顾2010年2月至2013年6月利用骨搬移技术治疗20例外伤性胫骨骨髓炎后大段骨缺损。男15例,女5例,年龄16-62岁,平均33岁。20例患者断端切新后骨缺损长度为6-10厘米,平均8厘米。术后定期复查调整力线,鼓励患者完全负重。结果:20例患者获得16月-40月(平均22.0月)随访。16例患者对合端直接愈合,其余4例患者对合端未能直接愈合。经重新切开植骨内固定最终愈合。骨延长长度为6-10厘米(平均8厘米)。外固定架指数为1.5-2月/cm。根据Paley骨愈合评分:优14例,良5例,差1例,优良率95%。结论:骨搬移治疗外伤性胫骨骨髓炎伴大段骨缺损安全有效。临床发现骨搬移的病例对合端有一期不能顺利直接愈合,现在目前机制和确切原因仍不清楚,但是经过局部后期处理并嘱患者坚持负重可最终愈合。
[Abstract]:Objective: to observe the effect of bone transfer in the treatment of large bone defect after traumatic tibial osteomyelitis. Methods: from February 2010 to June 2013, 20 cases of large bone defect after traumatic tibial osteomyelitis were treated with bone transfer technique. 15 males and 5 females, aged 16-62 years, ranged from 33 to 20 years old. The length of bone defect after amputation was 6-10 cm (mean 8 cm). Adjust the force line regularly after operation, encourage the patient to bear weight completely. Results Twenty patients were followed up for 16-40 months (mean 22.0 months). 16 cases were followed up. The involutive end healed directly in 16 cases and the other 4 cases failed to heal directly. The internal fixation was finally healed by reincision and bone grafting. The lengthening length of bone was 6-10 cm (mean 8 cm). The index of external fixator was 1.5-2 months / cm. According to Paley's bone healing score: excellent 14 cases, good 5 cases, poor 1 case, excellent and good rate 95%. Conclusion: bone transfer is safe and effective in the treatment of traumatic tibial osteomyelitis with large bone defect. It is found that the first stage of the involutive end of bone transfer can not be healed directly, but the mechanism and the exact cause are still unclear, but after local post-treatment and telling the patient to adhere to the load can finally heal.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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