开放引流自体植骨外固定治疗感染性骨不愈合

目的：研究开放引流、自体植骨、外固定治疗感染性骨不愈合的可行性及方法。方法：将治疗组的31例感染性骨不愈合患者，作组织丰厚区或原切口进入，“彻底”清除病灶，保留骨折端间的软性连接不切除，自体带骨膜露骨I期植骨，修复创面后行万向关节单臂外固定架或有效长腿半环开窗型石管外固定，无骨外露情况下切口开放引流。结果：31例患者28例一次手术后成功愈合，2例二次手术愈合，1例三次手术愈合，与同条件非同期传统方法治疗的病例相比较，有非常显著性差异(P＜0．01)。结论：开放引流、自体植骨、外固定能彻底有效控制感染，明显简化临床治疗过程，骨折端间的软性连接通过I期自体植骨最终骨化、矿化，直到骨性愈合，为感染性骨不愈合肢体功能恢复提供了新的外科治疗手段。

The treatment for infected nonunion by open drainge autograft of bone and esternal fisxtors

Objective: To study the feasibility and methods of the treatment for infected nonunion by open drainage autograft of bone and external fixators.Method: Thirty-one patients with treated nonunion were included in the study. Insions were done in the sites with rich soft tissue or in the original sites, After complete debridement and remaining the soft tissue connection between the two parts of the fracture , autoilium with periosteum of the fracture, autoilium with poruos teum was grafted by first intention . As soon as the wound was healed up, immobilization was done by arbitrary-direction one arm fixator and long-leg half cust paster external fixation. Open drainage was done if there was no external fixation devices. Results: Bone union occurred in 28 of 31 cases after one operation. Two cases achieved bone union after 2 operations and one after three operations. There was significant difference between these cases and those under the same conditions treated by traditional methods at the same time(P<0.01). Conclusion: Open drainage can control the infection completely and instantly, simplifying the process of clinical treatment. The soft tissue connection between the two parts of the fracture is ossified and mineralized in the end until long union occurs. The project affords new surgical treatment method for reconstruction of the limb with infected nonunion.