感染性骨不连骨缺损的骨外固定治疗

目的：报告１９８２～１９９５年应用半环槽式外固定器治疗３３例感染性骨不连骨缺损和重建伤肢长度的经验，并对本方法的治疗结果进行评估．方法：３３例中伤口感染者１７例，感染已静止者１６例，１５例合并有超过３ｃｍ的肢体短缩畸形，骨缺损３～９ｃｍ者６例．经彻底清创后，所有病例均采用骨外固定器行骨断端加压固定，９例同期或延期行干骺端截骨延长术．结果：在牢固稳定条件下，创面感染均迅速得到控制．３３例骨不连骨缺损经加压外固定后均于３～１１月达到愈合，平均愈合时间５．５月．肢体短缩者９例均恢复了肢体长度，达到了肢体长度的均衡．结论：多平面骨外固定是治疗感染性骨不连骨缺损的重要手段，在固定牢稳可靠的情况下，感染易于得到控制．

Application of External Skeletal Fixator in Treatment of Infected Nonunions with Bone Loss

Aim: To introduce our experience and evaluate the result of using half ring sulcated external skeletal fixator in the treatment of infected nonunions with bone loss and in the reconstruction of limb length, a retrospective study was performed in a series of 33 cases admitted to our department from 1982 to 1995. Methods: There were 17 cases with active infection, 15 cases with limb shortening >3 cm, and 6 cases with 3 9 cm bone defects in our group. After debridement, all the patients were treated with compressive external skeletal fixation. For 9 cases of limb discrepancy, both metaphyseal osteotomy and limb lengthening were performed at the same time in 4 cases and at two stage in 5. Results: All the nonunions united and eradication of infection were achieved within 3 11 months. For 9 cases of limb discrepancy, limb shortening was corrected. Conclusion: Multiplane external fixation is an important method in the treatment of infected nonunions. It is suggested that active infection will become quiescent once the fixation is inherently stable.