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浙江大学学报（医学版）
浙江大学学报（医学版）  2016, Vol. 45 Issue (6): 631-635    DOI: 10.3785/j.issn.1008-9292.2016.11.12
病例报告     
Ⅰ期植骨联合非接触钢板技术治疗股骨创伤后感染性骨缺损八例
高秋明, 薛云, 邓银栓, 周顺刚, 厉孟, 时培晟
兰州军区兰州总医院全军骨科中心创伤骨科, 甘肃 兰州 730050
One-stage bone grafting combined with non-contact plate technique for treatment of post-traumatic femoral osteomyelitis and bone defects
GAO Qiuming, XUE Yun, DENG Yinshuan, ZHOU Shungang, LI Meng, SHI Peisheng
Orthopaedic Trauma of Orthopaedics Center, Lanzhou General Hospital of PLA, Lanzhou 730050, China
 全文: PDF(1148 KB)  
摘要：

2012年7月至2015年7月，兰州军区兰州总医院对8例股骨创伤后骨髓炎患者彻底清创后采用锁定钢板非接触技术固定骨折端，钢板置于大腿外侧皮下、股外侧肌的外侧。Ⅰ期切取不带皮质髂骨颗粒状松质骨植在清创后血运良好的骨缺损部位，尽量充满死腔，术后放置引流管。8例均顺利完成手术，手术时间120～150 min，平均（130±10）min；术后使用抗菌药物6周；引流管平均放置时间为8 d左右；患者随访12～48个月，平均（19±7）个月。其中7例术后复查X线摄片显示骨愈合，平均愈合时间为（16±5）周；1例感染复发，再次清创后改行骨搬移术。8例均未发生钢板及螺丝钉断裂、松动及固定失败。
关键词： 骨折固定术/方法学;  骨移植;  骨髓炎/病因学;  股骨;  股骨骨折/外科学;  随访研究    
Abstract:

Eight patients with femoral osteomyelitis were admitted in Lanzhou General Hospital of PLA between July 2012 and July 2015. During the operation the femur was fixed with non-contact locking plate after thorough debridement. Iliac morselized cancellous bones without cortical bone were filled in the bone defect after debridement. The locking plates were placed in the lateral subcutaneous interface superficial to the vastus lateralis muscle. Drainage tubes were routinely placed postoperatively. The surgery was completed successfully in all patients, and the average operation time was (130±10) min (120-150 min). Intravenous antibiotics were administrated for 2 weeks and followed by 4 week-oral antibiotics after the operation in all 8 cases. Drainage tubes remained in situ about 8 days. All patients were followed up for 12-48 months, with an average of (19±7) months. Postoperative X-ray examination showed bone union in 7 cases with an average healing time of (16±5) weeks. One patient failed with relapsed infection, and was later treated with Ilizarov apparatus after secondary debridement. No plate and screw fracture, loose and fixation failure were observed in all 8 cases.
Key words: Fracture fixation/methods    Bone transplantation    Osteomyelitis/etiology    Femur    Femoral fractures/surgery    Follow-up studies
收稿日期: 2016-08-20
CLC:  R681.2  
作者简介: 高秋明(1970-),男,硕士,副主任医师,硕士生导师,主要从事创伤骨科及显微外科研究;E-mail:gaoqm001@sohu.com;http://orcid.org/0000-0003-2403-1082
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引用本文:

高秋明 等. Ⅰ期植骨联合非接触钢板技术治疗股骨创伤后感染性骨缺损八例[J]. 浙江大学学报（医学版）, 2016, 45(6): 631-635.

GAO Qiuming, XUE Yun, DENG Yinshuan, ZHOU Shungang, LI Meng, SHI Peisheng. One-stage bone grafting combined with non-contact plate technique for treatment of post-traumatic femoral osteomyelitis and bone defects. Journal of ZheJiang University(Medical Science), 2016, 45(6): 631-635.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2016.11.12    或    http://www.zjujournals.com/xueshu/med/CN/Y2016/V45/I6/631

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