清创后Ⅰ期同种异体骨移植治疗慢性骨髓炎

目的：避免Ⅱ期自体松质骨移植的缺点，探讨Ⅰ期同种异体骨移植重建慢性骨髓炎清创术后骨缺损的可行性。方法：1999年2月至2004年4月，35例慢性骨髓炎患者（8例骨不连）在我院接受清创后Ⅰ期同种异体骨移植方法治疗。结果：35例患者中平均随访28个月（13～55个月），32例（91．4％）获得感染控制。8例骨不连患者，其中4例骨愈合；1例因感染复发接受再次清创自体骨移植获得感染控制、骨连接；3例再不连患者，2例自体骨移植获得连接，1例再不连及另2例感染复发患者未接受再次治疗。结论：清创后Ⅰ期同种异体骨移植治疗四肢慢性骨髓炎可以获得较高的感染控制率，但是骨不连伴节段性骨缺损患者应用该方法治疗，骨再不连的发生率高。应慎用。

Treatment of limb chronic osteomyelitis with one-stage allograft

Objective:In order to avoid disadvantages of two-stage cancellus bone autograft,we investigated the feasibility of one-stage allograft for reconstructing bone defect from debridement of chronic osteomyelitis in limbs. Methods:Between Feb.1999 and Apr.2004,Thirty-five cases of chronic osteomyelitis(8 cases of nonunion) underwent one-stage allograft after debridement in our hospital.Results:Thirty-five cases were followed for an average period of 28 m(range from 13-55 m).Thirty-two cases(91.43%) recovered without infection,while infection was confirmed in 3 cases(8.57%).Four out of 8 cases of bone nonunion healed in 9.5 m on average(3-12 m), and another case of nonunion from infection recurrence 35 d after surgery also attained union after redebridement and autograft of ilium.Renonunion occurred in 3 cases,among which 2 healed after secondary operations adopting autograft.One case of renonunion and 2 cases of infection recurrence accepted no treatment.Conclusion: Infection control could be attained in the majority of patients when one-stage allograft after debridement was used to reconstruct bone defect in chronic osteomyelitis of the extremities.Renonunion,however,happened in a relative high rate,especially in cases with segmental bone defect.