【摘要】 目的探讨抗生素骨水泥结合关节融合术治疗脓性渗出期化脓性指间关节炎的临床效果。方法回顾性分析湘潭市二医院骨科2009年1月至2018年6月收治的9例脓性渗出期化脓性指间关节炎患者,所有患者均采用抗生素骨水泥结合关节融合术治疗。结果术后患指无侧方偏斜和旋转,无指体感觉异常。8例患处皮肤切口获得一期愈合,1例病灶清除+万古霉素骨水泥填充术后9 d出现皮肤切口渗液,有清稀液体流出,再次清创,开放引流后,创面逐渐愈合。所有患者获得12～18个月随访,平均14.33个月。1例环指近侧指间关节炎患者术后半年局部再次出现红肿,但X片未见死骨生成或虫噬样改变,仍考虑复发可能,予以静脉抗生素治疗4周,症状消失。8例患者对术后疗效满意。结论抗生素骨水泥结合关节融合术治疗脓性渗出期化脓性指间关节炎效果确切,可控制感染,降低复发率。更多还原

【Abstract】 Objective To investigate the clinical effect of antibiotic bone cement combined with arthrodesis in the treatment of purulent interphalangeal arthritis. Methods 9 cases of pyogenic interphalangeal arthritis in the period of purulent exudation were analyzed retrospectively from January 2009 to June 2018 in the Department of Orthopedics, the Second Hospital of Xiangtan. All patients were treated with vancomycin antibiotic bone cement combined with arthrodesis. Results There was no lateral deviation and rotation of the affected fingers, nor abnormal sensation of the fingers. Skin incision got healed in one stage in 8 cases, except one case occurred incision exudation 9 days after focus removal and bone cement filling, and the wound healed gradually after debridement and drainage. All patients were followed up for 12 to 18 months, with an average of 14.33 months. The proximal interphalangeal joint of the ring finger showed redness and swelling in one case half a year after operation, but there was no dead bone formation or phagocytosis like change in X-ray film, and the recurrence was still considered possible. The symptoms disappeared after 4 weeks of intravenous antibiotic treatment. Among them, there were 8 cases satisfied with the effect. Conclusion It is effective of antibiotic bone cement combined with arthrodesis in the treatment of purulent interphalangeal arthritis, which can control infection and reduce recurrence rate.更多还原