骨搬运与LCP结合植骨内固定治疗下肢感染性骨不连的比较

发布时间：2018-11-23 11:01

【摘要】：目的比较Ilizarov骨搬运技术与锁定加压接骨板(LCP)结合植骨内固定治疗下肢感染性骨不连的临床疗效。方法回顾性分析自2010-07—2015-04诊治的感染性骨不连22例,首先给予清创、VSD负压吸引及抗生素链珠置入控制感染,待感染控制良好后,进行Ilizarov骨搬运技术(骨搬运组11例)或LCP结合植骨内固定(LCP组11例)治疗。比较2组术中失血量、手术次数、感染控制率、住院时间、术后至开始部分负重时间及末次随访时AAOS评分。结果所有患者均获得随访3~35个月,平均24.2个月。末次随访时骨搬运组4例完全愈合恢复,7例感染消除,骨搬运已结束,处于骨愈合期;1例发生针道感染,常规换药加抗生素治愈。LCP组8例已完全恢复,3例出现感染,再次行手术治疗。与LCP组比较,骨搬运组术中失血量及手术次数较少,感染控制率更高,差异有统计学意义(P0.05)。2组住院时间、术后至开始部分负重时间、AAOS评分比较差异无统计学意义(P0.05)。结论 Ilizarov骨搬运技术治疗下肢感染性骨不连的感染控制率高,且能够有效保护软组织,促进其恢复,为肢体恢复长度提供保障。
[Abstract]:Objective to compare the clinical effect of Ilizarov bone transport technique and locking compression plate (LCP) combined with bone graft internal fixation in the treatment of infective bone nonunion of lower extremity. Methods 22 cases of infectious nonunion diagnosed and treated from 2010-07 to 2015-04 were retrospectively analyzed. First, debridement, VSD suction and antibiotic beads were performed to control the infection. Ilizarov bone transport technique (11 cases) or LCP combined with bone graft internal fixation (LCP group 11 cases) were performed. The amount of blood loss, the times of operation, the infection control rate, the time of hospitalization, the time of partial weight bearing from operation to the beginning of operation and the AAOS score at the last follow-up were compared between the two groups. Results all the patients were followed up for 3 ~ 35 months with an average of 24.2 months. At the last follow-up, 4 cases in the bone transport group recovered completely, 7 cases got rid of the infection, and the bone transport was finished, which was in the period of bone healing. One case developed needle infection and was cured by routine dressing change and antibiotics. In LCP group, 8 cases were completely recovered, 3 cases were infected and underwent surgical treatment again. Compared with LCP group, the amount of blood loss and the times of operation were less in bone handling group, and the infection control rate was higher (P0.05). There was no significant difference in AAOS score (P0.05). Conclusion the infection control rate of Ilizarov in the treatment of infective bone nonunion of lower extremity is high, and it can effectively protect soft tissue, promote its recovery and provide guarantee for the length of limb recovery.
【作者单位】：吉林大学第一医院创伤骨科;吉林省中医院骨伤科;
【分类号】：R687.3

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