| 李军 毕龙 薛宝宝 刘彦温 柴云峰 蔡鹏武.下肢大段感染性骨缺损的治疗[J].,2015,15(23):4477-4480 |
| 下肢大段感染性骨缺损的治疗 |
| Treatment for the Segmental Infectious Bone Defect in Lower Extremities |
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| DOI： |
| 中文关键词: 感染性骨缺损 下肢 腓骨瓣 骨搬运 |
| 英文关键词: Infective bone defect Lower extremity Fibular skeletal flaps Bone transport |
| 基金项目:国家自然科学基金项目（81371982） |
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| 中文摘要: |
| 目的：探讨应用骨搬运、自体腓骨瓣移植辅助皮瓣移植等技术治疗下肢大段感染性骨缺损的疗效。方法：对2006 年6 月至
2012 年6月收治的43 例男性、20 例女性下肢大段感染性骨缺损患者的治疗效果进行回顾性研究。所有患者均在彻底清创基础
上分别应用骨搬运技术和自体腓骨瓣移植技术进行骨缺损的同期修复。其中，采用骨搬运技术治疗28 例，采用腓骨瓣移植技术
治疗35 例，包括单纯腓骨瓣14 例、腓骨皮瓣移植9 例、腓骨瓣+股前外侧皮瓣移植12 例。结果：63 例患者术后获6~26 个月(平
均17.2 个月)的随访。除3 例感染未能控制外，其余60 例患者下肢畸形或残缺均得到矫正，负重力线、肢体外观及功能基本恢复，
未出现严重并发症。参照Johner-wruhs疗效评定标准：优28 例，良23 例，可6 例，差6 例，优良率为81.0%。结论：下肢大段感染性
骨缺损往往涉及骨、肌肉、皮肤软组织等诸多环节，应根据病情需要采用综合的治疗方式，以保存患者的肢体功能、减少手术次
数、缩短治疗时间和节省治疗费用。 |
| 英文摘要: |
| Objective:To investigate the clinical efficacy of various methods such as bone transport, fibular autograft alone or
combined with skin flap in the treatment of segmental infectious bone defects in lower extremities.Methods:From June 2006 to June
2012, 43 male and 20 female patients with segmental infectious bone defect in lower extremities in accordance with the inclusion criteria
were observed under a retrospective study. All the patients were treated at one-stage after a strict debridement. Various types of methods
were used to repair the defects: bone transport were used in 28 cases, fibular autografts were used in 35 cases including 14 cases of
simple fibular autografts, 9 cases of fibular with skin flaps and 12 cases of fibular grafts combined with anterior lateral thigh flaps.Results:All the patients were followed up 6 to 26 months, mean 17.2 months. Except 3 cases of uncontrolled infection, the limb
deformities or bone defects of other 60 patients were repaired successfully. In these 60 cases, the load line of force, physical appearance
and function recovered, no serious complications were found. The limbs function of all the patients were evaluated by Johner-Wruhs
score, 28 cases were excellent, 23 cases were good，6 cases were fair and 6 cases were poor, the total excellent and good rate was 81.0%.Conclusion:Segmental infectious bone defect in lower extremities always involved the injury of bone, muscle, skin and soft tissue, the
treatments should carry out according to the disease to save the patients' limb function, reduce the number of operations, shorten the
treatment time and get the cost-saving treatment. |
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