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NRD辅助Ilizarov技术治疗胫骨感染性骨与软组织缺损
引用本文:杨华清,章耀华,李强,张鸿悦,赵殿钊,韩庆海,杨云,杨启昌,曲龙.NRD辅助Ilizarov技术治疗胫骨感染性骨与软组织缺损[J].中国骨伤,2022,35(10):921-926.
作者姓名:杨华清  章耀华  李强  张鸿悦  赵殿钊  韩庆海  杨云  杨启昌  曲龙
作者单位:首都医科大学附属北京康复医院骨科, 北京 100144
基金项目:首都临床特色应用研究(编号:Z141107002514040);首都临床特色应用研究与成果推广(编号:Z161100000516126)
摘    要:目的:探讨NRD辅助Ilizarov技术治疗胫骨感染性骨与软组织缺损的临床疗效。方法:选取2013年3月至2020年12月治疗的胫骨感染性骨与软组织缺损患者48例,男34例,女14例,年龄24~55(40.54±11.64)岁,分为研究组与对照组。研究组患者25例,男17例,女8例,年龄31~55(41.36±9.69)岁,采用NRD辅助Ilizarov骨搬移技术治疗。对照组23例患者,男17例,女6例,年龄24~53(38.61±8.76)岁,采用传统骨搬移技术治疗。通过两组患者的治愈率、复发率、针道感染发生率、抗生素使用时间、创面愈合时间、外固定携带时间、骨搬移时间、骨愈合情况、术后功能等指标评价治疗效果。结果:随访时间12~62(33.0±7.2)个月,末次随访时,两组患者的治愈率比较,差异无统计学意义(P>0.05),研究组复发率低于对照组(P<0.05),针道感染发生率低于对照组(P<0.05)。研究组的抗生素使用时间、创面愈合时间均少于对照组(P<0.05),两组之间的骨搬移时间、外固定携带时间差异无统计学意义(P>0.05),两组骨愈合情况、术后功能差异无统计学意义(P>0.05)。结论:NRD辅助Ilizarov技术治疗胫骨感染性骨与软组织缺损,可以达到满意的治疗效果,缩短了治疗周期及抗生素使用时间。

关 键 词:Ilizarov技术|骨搬移|骨髓炎|骨缺损|骨不连|NRD
收稿时间:2022/9/21 0:00:00

NRD assisted Ilizarov technique in the treatment of infected bone and soft tissue defect of tibia
YANG Hua-qing,ZHANG Yao-hu,LI Qiang,ZHANG Hong-yue,ZHAO Dian-zhao,HAN Qing-hai,YANG Yun,YANG Qi-chang,QU Long.NRD assisted Ilizarov technique in the treatment of infected bone and soft tissue defect of tibia[J].China Journal of Orthopaedics and Traumatology,2022,35(10):921-926.
Authors:YANG Hua-qing  ZHANG Yao-hu  LI Qiang  ZHANG Hong-yue  ZHAO Dian-zhao  HAN Qing-hai  YANG Yun  YANG Qi-chang  QU Long
Institution:Department of Orthopaedics,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China
Abstract:Objective: To investigate the clinical effect of NRD assisted Ilizarov technique in the treatment of infected bone and soft tissue defect of tibia. Methods: All 48 patients with infected bone and soft tissue defect of tibia were randomly divided into study group and control group from March 2013 to December 2020. There were 34 males and 14 females,aged from 24 to 55 years old with an average of (40.54±11.64) years old. There were 25 patients in the study group,including 17 males and 8 females,aged from 31 to 55 years old with an average of (41.36±9.69) years old. The study group were treated with NRD assisted with Ilizarov bone transport technique. There were 23 patients in control group,including 17 males and 6 females,aged from 24 to 53 years old with an average of(38.61±8.76) years old. The control group were treated with traditional bone transport technique. The curative rate,recurrence rate,incidence rate of pin track infection,time of using antibiotics,time of wound healing,time of carrying external fixation,time of bone transport,time of bone healing and postoperative function were used to evaluate the therapeutic effect of the two groups. Results: The follow-up period was from 12 to 62 months with an average of (33.0±7.2) months. At the final follow-up,there was no significant difference in the curative rate between the two groups (P>0.05). The recurrence rate in the study group was lower than that in the control group(P<0.05). The incidence of pin track infection in the study group was lower than that in the control group (P<0.05). The time of using antibiotics and wound healing in the study group was shorter than that in the control group(P<0.05). There was no significant difference in the time of bone transport and carrying of external fixation between the two groups(P>0.05). There was no significant difference in bone healing and postoperative function between the two groups(P>0.05). Conclusion: NRD assisted Ilizarov technique can achieve satisfactory results in the treatment of infected bone and soft tissue defect of tibia and shorten the treatment period and the time of using antibiotics. It is worthy of development in clinic.
Keywords:Ilizarov technique|Bone transport|Osteomyelitis|Bone defect|Bone nonunion|Nose ring drainage
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