骨搬移技术治疗慢性骨髓炎伴骨缺损并发症的研究进展
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刘亦杨 LIU Yi-yang 浙江省立同德医院骨科, 浙江 杭州 310012 Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China orthopaedic_liuyy@163.com 
林炳远 LIN Bing-yuan 浙江省立同德医院骨科, 浙江 杭州 310012 Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China  
黄凯 HUANG Kai 浙江省立同德医院骨科, 浙江 杭州 310012 Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China  
沈立锋 SHEN Li-feng 浙江省立同德医院骨科, 浙江 杭州 310012 Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China  
张春 ZHANG Chun 浙江省立同德医院骨科, 浙江 杭州 310012 Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China  
郭峭峰 GUO Qiao-feng 浙江省立同德医院骨科, 浙江 杭州 310012 Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China  
期刊信息:《中国骨伤》2020年,第33卷,第3期,第288-292页
DOI:10.12200/j.issn.1003-0034.2020.03.022
基金项目:
中文摘要:搬移技术(Ilizarov技术)有效解决了慢性骨髓炎伴结构性骨缺损这一临床难题,但该方法存在对合端不愈合、延长间隙矿化不良等严重骨性愈合相关的并发症。术中对搬移骨段力线的维持、截骨端组织的保护;术后合适的搬移速率和应力刺激,以及"手风琴技术"的应用,是降低此类并发症的关键。目前对于外固定架的拆除时机仍有较大争议,一旦因过早拆除引起再发骨折仍需尽早积极手术治疗。此外,需减少术中钉道局部热损伤以及加强术后钉道护理,以预防钉道感染的发生。而全程合理的镇痛方案结合积极的功能锻炼,是避免邻近关节功能障碍发生的重要方法。
【关键词】Ilizarov技术  骨髓炎  手术后并发症  综述
 
Progress on complications of chronic osteomyelitis with bone defect treated by bone transportation
ABSTRACT  Bone transportation technology(Ilizarov technique) effectively solves the clinical problem of chronic osteomyelitis with structural bone defect. The paper combined with own clinical experience and a large number of literatures,the results showed that this method had some complications related to severe bone healing,such as non-union of the joint ends and poor mineralization of the extended gap. Maintenance of force line during operation,protection of osteotomy end tissues,appropriate transporting velocity and stress stimulation after operation,and application of "accordion technology" are the keys to reduce such complications. At present,there is still much controversy about the timing of removal of external fixator. Once the re-fracture is caused by early removal,it must be treated actively as soon as possible. In addition,it is necessary to reduce the local thermal injury of nail canal during operation and strengthen the nursing of nail canal after operation in order to prevent nail canal infection. Reasonable analgesic regimen combined with active functional exercise is an important method to avoid the occurrence of adjacent joint dysfunction.
KEY WORDS  Ilizarov technique  Osteomyelitis  Postoperative complications  Review
 
引用本文,请按以下格式著录参考文献:
中文格式:刘亦杨,林炳远,黄凯,沈立锋,张春,郭峭峰.骨搬移技术治疗慢性骨髓炎伴骨缺损并发症的研究进展[J].中国骨伤,2020,33(3):288~292
英文格式:LIU Yi-yang,LIN Bing-yuan,HUANG Kai,SHEN Li-feng,ZHANG Chun,GUO Qiao-feng.Progress on complications of chronic osteomyelitis with bone defect treated by bone transportation[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(3):288~292
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