灌洗、筋膜蒂皮瓣及外固定架I期治疗胫骨感染性不愈合、骨外露

目的评价灌洗、筋膜蒂皮瓣及外固定架I期治疗胫骨感染性不愈合、骨外露的疗效。方法对15例胫骨骨折感染性不愈合、骨外露患者,应用病灶内抗生素持续灌洗、骨外露处软组织缺损筋膜蒂皮瓣修复、骨折不愈合外固定架加压固定综合方法I期治疗,对骨感染治疗情况、骨外露软组织缺损修复情况及骨折愈合情况进行评价。结果15例患者骨折全部愈合,愈合时间3～6个月,骨外露软组织缺损处筋膜蒂皮瓣全部成活,伤口I期愈合13例,II期愈合2例,骨感染经1～1.5年随访无复发。结论灌洗、筋膜蒂皮瓣及外固定架I期综合治疗方法,具有兼顾控制感染、消灭软组织缺损创面和促进骨折愈合的优点,是治疗胫骨感染性不愈合、骨外露的有效、可行的方法。

Use of instillation-suction technique and fascinocutaneous flap and external fixator in infected nonunion and soft tissue defects of the tibia

[Objective] To evaluate clinical effect of the infected nonunion and soft tissue defects of the tibia with instillation-suction technique and fasciocutaneous flap and external fixation. [Methods] 15 cases of the infected nonunion and soft tissue defects of the tibia were treated with persistent instillation-suction of antibiotic and repairing the soft tissue defects by fasciocutaneous flap and pressor fixation of nonunion bone by external fixation during 8 years. [Results] Bone union were achieved in all cases by 3 to 6 months. The fasciocutaneous flap of repairing the defects were all survived and the healing of infection were followed-up by to 1.5 years. [Conclusion] The composite treatment of instillation-suction technique and fasciocutaneous flap and external fixation were a reliable therapy of infected nonunion and soft tissue defects of the tibia. It has advantages of control of infection and repairing the defects of soft tissue and accelerating union of the infected tibia at the same time.