AO外固定器结合一期白体骨移植治疗胫骨感染性骨不连

目的探讨胫骨感染性骨不连的治疗方法。方法对25例胫骨感染性骨不连的患者在术前和术后应用有效抗生素的基础上，彻底清除病灶，切除失活的软组织和骨组织，切除骨折断端之间的纤维组织，再通骨髓腔．并依骨缺损的长度进行一期自体骨移植，同时用AO外固定器进行加压固定。术后严格无菌换药，并使用敏感抗生素，平均用药12～14d．结果全部病例均于术后4—16mo，平均6-8mo达到骨性愈合，肢体长度均衡。结论AO外固定器结合一期自体骨移植是治疗胫骨感染性骨不连和骨缺损的简单、积极而有效的方法。与传统方法相比，疗程缩短，手术次数减少。

The treatment of the infected tibial nonunion by open bone grafting and AO external fixators

Objective To investigate the treatment of the infected tibia nonunion. Methods 25 patients with infected tibial nonunion were included in this study. On the basis of the preoperative and postoperative effective application of anitibiotic, the lesion were eliminated completely by excising non-viable tissue and the fiber organizations in the infected tibia. Then the autologous ilium was grafted to the tibia to repair defects.At last, the external fixation device was used to fix the tibia. After operation,the changing dressing in asepsis and effective anitibiotic were necessary.The average time was 12-14 days.Results All the patients had bone union within 3 to 14 months （ average 6 to 8 months）. The infection was completely controlled, the wound went on healing and the length of the limb was maintained. Conclusions The treatment by open bone grafting and AO external fixators is simple,active and effective for the infected tibial nonunion and defects.Compared with the traditional treatment,the period of treatment was shorter, the operation was reduced.