改良Illizarov技术治疗下肢感染性骨缺损

目的研究改良Illizarov技术治疗下肢感染性骨缺损和肢体短缩的方法。方法感染性骨缺损患者23例,男20例,女3例;年龄21~49岁,平均32岁。股骨7例,胫骨16例。肢体短缩4~17cm,平均9cm。根据Illizarov治疗原则,采用微创截骨,分别采用骨段滑移术修复骨缺损和延长肢体。结果经骨段滑移,骨缺损全部愈合,延长间隙成骨良好,无一例需补充植骨。23例经1~5年随访,所有骨缺损愈合,肢体长度恢复正常,感染无复发。结论骨段滑移技术是治疗下肢大段骨缺损简单而有效的方法,软组织感染创面可在骨段滑移中逐渐缩小并闭合,骨感染可在骨段滑移中逐渐被控制并随骨连接而愈合。

Treatment of infected bone defect of lower limbs with improved Illizarov technique

Objective:To study the treatment of infected bone defect and limbs shortening in adults with improved Illizarov technique.Methods:Twenty-three patients with infected bone defect(20 male and 3 female,the average age of 32 years,ranging from 21 to 49 years)were treated.The fracture position was at femur in 7 cases and tibia in 16.The length of limb shortened 4 to 17 cm(mean 9 cm).All the cases with bone defected treated with external fixation and minimal incisional osteotomy/According to Illizarov method,the bone segmental frifting was used for nonunion and limb shortening respectively.Results:After bone segment frifting,the bone defect healed,the space of lengthening ossified well without bone graft.All the cases were followed up for 1 to 5 years.Limb length in all the cases returned to normal and bone defect was repaired without relapse.Conclusion:The technique of bone segment frifting is a simple and effective method for bone defect.Traumatic face of soft tissue can decrease and close,and the bone infection can be controlled gradually during the bone segment frift.Finally,the infection can be healed with the bone union.