髓内钉结合载抗生素硫酸钙辅助Ilizarov环形外固定架骨搬运治疗胫骨感染性骨缺损

目的 分析髓内钉结合载抗生素硫酸钙辅助Ilizarov环形外固定架骨搬运治疗胫骨感染性骨缺损患者的临床效果.方法 回顾性分析2018年1月-2020年1月于西安交通大学附属西安市红会医院创伤病院下肢病区治疗并接受手术的11例胫骨骨感染清创后存在骨缺损的患者的临床资料.其中男性7例,女性4例;年龄32～67岁,平均年龄(...

Tibial bone transport over an intramedullary nail in combination with antibiotic-loaded calcium sulphate for treatment of segmental bone defect

Objective To analyze the clinical outcomes of tibial bone transport over an intramedullary nail in combination with antibiotic-loaded calcium sulphate for treatment of segmental bone defect.Methods A retrospective analysis was conducted by enrolling 11 surgically treated patients with tibial segmental bone defect after the debridement for tibial infection or osteomyelitis who were admitted in Lower Limb Surgery Ward of Traumatic Orthopedic Department,Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University from Jan.2018 to Jan.2020.The collected clinical materials and data included gender,age,injury mechanism,smoke or alcohol,comorbidities,intraoperative bleeding loss,bone defect length,resorption time of calcium sulphate,bone transport time,external fixation time,external fixation index,complications and Paley bone and functional criteria.SPSS 24.0 software was used to analyze the data.Results Eleven patients were followed up for 8 to 31 months(average 23.2 months).All patients achieved bone healing and the infection was eradicated with no sign of recurrence.The mean length of defect was(8.1±1.6)cm,mean resorption time of calcium sulphate was(6.6±2.6)months,bone transport time was(11.4±2.8)weeks,external fixation time was(4.7±1.2)months,external fixation index was(0.58±0.07)month/cni and full weight bearing time was(6.1±1.4)months.The complication rate was 36.4%including deep vein thrombosis,delayed union of the docking site,pin tract infection and sterile draining of the wound.Paley bone evaluation results were excellent and good in 10 patients(90.9%)and functional results were excellent and good in 11 patients(100%).Conclusion Tibial bone transport over an intramedullary nail in combi nation with antibiotic-loaded calcium sulphate is a safe,reliable and successful method for segmental bone defect and eradication of infection which reduces external fixation time and complication rate,allows patients perform weight bearing and return to daily life earlier.