Ilizarov外固定器结合病灶清除及植骨术在治疗感染性骨不连及慢性骨髓炎的应用

【摘要】〓目的〓探讨应用Ilizarov外固定器治疗骨感染和骨不连的技术和经验。方法〓2012年~2013年,对18例骨感染和骨不连病人接受治疗,其中感染性骨不连12例,骨髓炎6例。根据感染的部位和范围预先在患肢安装Ilizarov外固定器,将感染波及的骨干彻底整段切除后,再在缺损段的远或(和)近侧干骺端行一期截骨延长。结果〓16例患者一期伤口痊愈且无破溃,骨愈合良好,随访10个月无骨髓炎复发的表现。2例患者术后1个月再次伤口破溃流脓,提示感染复发,按上述方法重新治疗后愈合。随访12~18个月,所有患者均达到骨性愈合,肢体外观和功能效果令人满意。结论〓应用Ilizarov技术,采用大段病骨切除同时截骨延长的方法是治疗外伤后感染性骨不连与骨髓炎的有效方法,并同时恢复肢体长度和矫正马蹄足畸形。

Ilizarove external fixator appatatus combined with focal cleaning and bone grafting in the treatment of infected bone nonunion and chronic osteomyelitis

Objective To investigate the clinical effect of Ilizarov device in treating infected bone nonunion and osteomyelitis. Methods From 2012 to 2013, 18 cases with infected bone nonunion with osteomyelitis were operated in our hospital. Twelve of them were infected nonunion and 6 cases were osteomyelitis. All patients underwent one-stage of truncation for bone-extension and fixed with Ilizarov device after debridement in injury part. Results Sixteen cases were healed both in fracture and infection. Two cases were infected again one month after operation, then the same method was performed and the patients got well healed. After 10 to 18 months of follow-up, no recurrence was found. Conclusion Application of Ilizarov device has good efficacy in treatment of infected bone nonunion and osteomyelitis by one-stage of truncation for bone-extension.