| 膜诱导技术治疗成人长骨慢性骨髓炎早期临床疗效 |
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Received:March 07, 2014
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| 作者 | Author | 单位 | Unit | E-Mail |
| 解冰 |
XIE Bing |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 田竞 |
TIAN Jing |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 荆延峰 |
JING Yan-feng |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 周大鹏 |
ZHOU Da-peng |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
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| 项良碧 |
XIANG Liang-bi |
沈阳军区总医院骨科, 辽宁 沈阳 110016 |
Department of Orthopaedics, Shenyang Military Region General Hospital, Shenyang 110016, Liaoning, China |
xiangliangbi1963@126.com |
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| 期刊信息：《中国骨伤》2015年28卷，第1期，第43-47页 |
| DOI：10.3969/j.issn.1003-0034.2015.01.011 |
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目的: 探讨膜诱导技术治疗成人长骨慢性骨髓炎清创后大段骨缺损的早期临床疗效.
方法: 2010年3月至2012年3月共收治成人长骨慢性骨髓炎23例,男15例,女8例;年龄26～49岁,平均35.2岁;16例初始损伤为开放性骨折,6例为闭合性骨折,1例无骨折病史.胫骨12例,股骨7例,肱骨3例,尺桡双骨1例;骨干19例,干骺端4例.病程4～13个月,平均6.9个月.所有患者采用膜诱导技术分2个阶段治疗,记录患肢术后并发症、骨愈合时间及功能情况,并采用中文版SF-36量表评定手术疗效.
结果: 所有患者获随访,时间18～43个月,平均(27.6±5.3)个月.术后2例出现皮瓣边缘部分坏死,1例髂骨切口浅表感染,余无明显围手术期并发症发生.20例获得Ⅰ期骨愈合,平均愈合时间4.6个月(3～7个月),其中16例下肢手术患者完全负重时间5.2个月(4～8个月);3例随访期间出现感染,再次接受膜诱导手术后达到完全骨愈合.末次随访时SF-36量表各维度得分及总分较术前改善.
结论: 膜诱导技术可以有效解决成人长骨慢性骨髓炎清创后大段骨缺损问题,显着缩短治疗周期,手术操作简单,术后并发症少,患肢功能恢复良好,早期疗效满意. |
| [关键词]:骨髓炎 创伤和损伤 成年人 外科手术 |
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| Early effect of induced membrane technique for the reconstruction of chronic osteomyelitis defects in limbs of adult patients |
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Abstract:
Objective: To investigate the early clinical efficacy of induced membrane technique for reconstruction of large bone defects after debridement in adults with chronic osteomyelitis of limbs.
Methods: From March 2010 to March 2012,a total of 23 adult patients with chronic osteomyelitis of limbs were treated in our department. There were 15 males and 8 females,with a mean age 35.2 years old(ranged from 26 to 49 years old). Sixteen patients had open fracture history. According to the lesion site,there were 12 cases of tibia,7 cases of femur,3 cases of humerus,and 1 case of both radius and ulna. Among them,19 patients had diseases in diaphysis and 4 patients in the metaphysis. The mean interval from infection to operation was 6.9 months (ranged from 4 to 13 months). All the patients were treated by using induced membrane technique. The follow up evaluation included clinical complications,time of bone healing,and limbs function. The Chinese version of SF-36 scores was used in the assessment of quality of life pre and post operation.
Results: The average duration of follow up was (27.6 ± 5.3) months (ranged from 18 to 43 months). Two patients had postoperative flap edge necrosis,1 patient had superficial iliac incision infection,no obvious complications were recorded. Twenty patients obtained radiological union at a mean time of 4.6 months (ranged from 3 to 7 months). Among them,16 patients treated with lower limbs surgery achieved full weight bearing at about 5.2 months (ranged from 4 to 8 months) postoperatively. Four patients suffered from reinfection during follow up,but 3 of them achieved complete bone healing after the second surgeries with induced membrane technique. At the final follow up,there was a substantial improvement in each dimension scores and total scores of SF-36 as compared with those before surgery.
Conclusion: When treating with adult chronic osteomyelitis of limbs,the induced membrane technique can effectively reconstruct large bone defects after debridement,significantly shorten treatment cycle,provide satisfactory results with minimal complications,promote good recovery of limbs function and require relatively simple operation technique. |
| KEYWORDS:Osteomyelitis Wounds and injuries Adult Surgical procedures,operative |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 解冰,田竞,荆延峰,周大鹏,项良碧.膜诱导技术治疗成人长骨慢性骨髓炎早期临床疗效[J].中国骨伤,2015,28(1):43~47 |
| 英文格式: | XIE Bing,TIAN Jing,JING Yan-feng,ZHOU Da-peng,XIANG Liang-bi.Early effect of induced membrane technique for the reconstruction of chronic osteomyelitis defects in limbs of adult patients[J].zhongguo gu shang / China J Orthop Trauma ,2015,28(1):43~47 |
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