[1]王栋,张乐,乔虎云,等.分期治疗股骨骨折术后慢性骨髓炎的临床疗效研究[J].中华老年骨科与康复电子杂志,2022,(04):197-204.[doi:10.3877/cma.j.issn.2096-0263.2022.04.002]
　Wang Dong,Zhang Le,Qiao Huyun,et al.Clinical efficacy of staged treatment of chronic osteomyelitis after femoral fracture surgery[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2022,(04):197-204.[doi:10.3877/cma.j.issn.2096-0263.2022.04.002]
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分期治疗股骨骨折术后慢性骨髓炎的临床疗效研究()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2022年04期
页码:
197-204
栏目:
股骨骨折
出版日期:
2022-08-05

文章信息/Info

Title:
Clinical efficacy of staged treatment of chronic osteomyelitis after femoral fracture surgery
作者:
王栋1; 2; 张乐2; 乔虎云1; 刘宏1; 王宝娜1; 李岩1; 王钞崎2; 李超2; 贾英伟1; 张永红1
030001 太原，山西医科大学第二医院骨科1；030001 太原，山西医科大学2
Author(s):
Wang Dong1; 2;  Zhang Le2;  Qiao Huyun1;  Liu Hong1;  Wang Baona1;  Li Yan1;  Wang Chaoqi2;  Li Chao2;  Jia Yingwei1;  Zhang Yonghong1.
1The Second Hospital of Shanxi Medical University, Taiyuan 030001, China; 2Shanxi Medical University, Taiyuan 03001, China
关键词:
外固定架;  骨缺损;  慢性骨髓炎;  股骨骨折
Keywords:
External fixator;  Bone defect;  Chronic osteomyelitis;  Femoral fracture
DOI:
10.3877/cma.j.issn.2096-0263.2022.04.002
文献标志码:
A
摘要:
目的 研究股骨骨折术后慢性骨髓炎合并骨不愈合和骨缺损患者经分期治疗的临床疗效和影响因素。方法 回顾性分析自2012年5月至2020年7月山西医科大学第二医院骨科经分期治疗的股骨骨折术后慢性骨髓炎患者17例，男性13例，女性4例，年龄9～59岁，平均（30±15）岁；原始外伤为开放伤10例，闭合损伤7例；初次固定为内固定11例，外固定6例。经一期控制感染；二期根据骨缺损情况分别选用骨搬移重建骨组织者6例，应用骨移植者11例。结果 17例均获得随访，随访时间17～33个月。患者带外架时间为11～30个月；其中二期骨搬移带架时间15～28个月，中位数为27（17.25，28.5）个月；二期植骨术带架时间11～20个月，中位数为18个月（17，19）。接受二期植骨患者手术次数为2～3次，平均2（2，3）次，接受二期骨搬移患者手术次数为3次，平均3（3，3）次。感染均获得治愈。末次随访Paley骨愈合评价均为优。结论 分期治疗股骨骨折术后慢性骨髓炎疗效可靠。术前准确判断感染范围可在有效控制感染的同时减少组织缺损范围，缩短治疗时间。
Abstract:
Objective To study the clinical efficacy and influencing factors of staged treatment in patients with chronic osteomyelitis complicated with bone nonunion and bone defect after femoral fracture surgery. Methods A retrospective analysis of 17 patients with chronic osteomyelitis after femoral fractures treated by stages from May 2012 to July 2020 in the department of orthopedics, second hospital of shanxi medical university, including 13 males and 4 females, aged 9-59 years, mean (30±15) years old; The original trauma was open injury in 10 cases and closed injury in 7 cases; the primary fixation was internal fixation in 11 cases and external fixation in 6 cases. In the first stage, the infection was controlled; in the second stage, according to the bone defect, bone transfer was utilized in 6 cases to reconstruct bone tissue, and 11 cases were treated with bone graft. Results Seventeen cases were followed up for 17-33 months. The time of the patients with the external frame was 11-30 months; the time of the second-stage bone transport with the frame was 15-28 months, and the median was 27 (17.25, 28.5) months, the time of the second-stage bone grafting with the frame was 11-20 months, and the median was 18 (17, 19) months. The number of operations for patients who received two-stage bone transport was 2-3 times, with an average of 2 (2, 3) times, and the number of operations for patients who received two-stage bone grafting was 3 times, with an average of 3 (3, 3) times. Infections were cured. The Paley evaluation of bone healing at the last follow-up was excellent. Conclusions Staged treatment of chronic osteomyelitis after femoral fracture is reliable. Accurately judging the scope of infection before surgery can effectively control the infection while reducing the scope of tissue defects and shortening the treatment time.

备注/Memo

备注/Memo:
基金项目：国家自然科学基金（82172439）
更新日期/Last Update: 2022-09-29