【摘要】 目的分析自制抗生素骨水泥髓内钉结合锁定钢板(LCP)外固定治疗胫骨感染性骨不连的手术技术和临床效果。方法回顾性分析本院自2005-03—2014-07诊治的13例胫骨感染性骨不连。取出内固定、清创、扩髓并置入自制抗生素骨水泥髓内钉,6~12周后改用LCP外固定+自体骨、Wright人工骨混合万古霉素植骨。结果 13例均获得随访13~24个月,平均15.6个月。所有患者感染均得到控制,在拆除抗生素骨水泥髓内钉时细菌培养均为阴性,血常规、红细胞沉降率、C反应蛋白正常。受伤至抗生素骨水泥髓内钉置入的时间为8~12个月,平均10.3个月。抗生素骨水泥髓内钉放置时间为6~12周,平均8.3周。骨折最终均愈合,其中1例延迟愈合,LCP外固定后骨折愈合时间平均5.8个月。末次随访时根据Olerud-Molander评分标准评定踝关节功能:优10例,良3例。结论自制抗生素骨水泥髓内钉结合LCP外固定治疗胫骨感染性骨不连简单实用、效果确切,值得推广。更多还原

【Abstract】 Objective To evaluate the surgical technique and clinical results of the homemade antibiotic bone cement nail combined with locking compression plate as external fixation in treatment of infected nonunion of the tibia. Methods Thirteen cases of infected nonunion of the tibia from March 2005 to July 2014 treated in our hospital was retrospectively studied. The internal fixation was removed, debridement, reaming were performed and homemade antibiotic bone cement intramedullary nail was implanted, and 6-12 weeks later the locking compression plate as external fixation were used. Results Thirteen patients were followed up for 13 to 24 months, an average of 15.6 months. All infections were controlled, culture of the removal of nail antibiotic bone cement were negative, blood, erythrocyte sedimentation rate, C-reactive protein were normal. The time from injury to implant the homemade antibiotic bone cement nail was 8 to 12 months, an average of 10.3months. Antibiotic bone cement nail placement was for 6 to 12 weeks, an average of 8.3 weeks. All fractures were healed, one case got delayed union, the average healing time after locking compression plate as external fixation was 5.8 months.According to Olerud Molander ankle score, excellent in 10 cases, good in 3 cases. Conclusion Homemade antibiotic bone cement nail combined with locking compression plate as external fixation is an effective treatment for infected nonunion of the tibia. This technique is simple, practical, effective and is worthy to be spread.更多还原