USE OF THE ILIZAROV TECHNIQUE FOR TREATMENT OF NONUNION OF THE TIBIA ASSOCIATED WITH INFECTION
USE OF THE ILIZAROV TECHNIQUE FOR TREATMENT OF NONUNION OF THE TIBIA ASSOCIATED WITH INFECTION
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DOI：
10.2106/00004623-199506000-00004
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发表时间：
1995-06-01
影响因子：
5.3
通讯作者：
LYRITSIS, E
中科院分区：
文献类型：
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作者：
DENDRINOS, GK;KONTOS, S;LYRITSIS, E
对28例18~74岁的胫骨感染性骨不连患者行骨坏死根治术和骨牵引成骨治疗。同时处理骨不连、感染、短缩、畸形和骨质疏松，所有患者均采用骨转移技术进行单节段或两节段骨延长，即将一块骨块移向骨不连部位，通过牵张成骨修复缺损区。被桥接的骨缺损大小平均为6厘米(范围2~13厘米)。所有患者在取出固定器前感染均已根除，平均治疗时间为10个月，从中间节段与靶段接触之日起计算，平均愈合时间为6个月，平均随访时间为39个月，成功矫正了腿长畸形和不等长，28例患者中，14例分别小于7度和2.5厘米，按骨折愈合、感染愈合、畸形状况、残端短缩程度判定为优，其余14例中，8例骨性效果良好；一是公平的结果；五是糟糕的结果。功能优7例，良11例，可4例，差5例，截肢1例，骨折愈合困难3例(11%)，1例再次骨折截肢，25例(89%)出现严重或轻度并发症，每例2.5例。
Non-union of the tibia associated with infection was treated with radical resection of the necrotic bone and distraction osteogenesis in twenty-eight patients who were eighteen to seventy-four years old. Non-union, infection, shortening, deformity, and osteoporosis were all addressed simultaneously, All patients had either one-segment or two-segment lengthening of bone with a technique of bone transport in which a bone fragment is moved toward the site of non-union, leaving a defect that is bridged by distraction osteogenesis. The size of the bone defect that was bridged averaged six centimeters (range, two to thirteen centimeters).The infection was eradicated in all patients before the fixator was removed, The mean duration of treatment was ten months, The mean time to union, calculated from the day that the intercalary segment came into contact with the target segment, was six months, The mean duration of follow-up was thirty-nine months, The deformity and the inequality of the lengths of the legs were corrected successfully - to less than 7 degrees and to less than 2.5 centimeters, respectively in fourteen of the twenty-eight patients, In these fourteen patients, the bone result - determined according to the criteria of union, healing of the infection, status of the deformity, and amount of residual shortening was considered excellent, Of the fourteen remaining patients, eight had a good bone result; one, a fair result; and five, a poor result. The functional result was excellent in seven patients, good in eleven, fair in four, and poor in five, One patient had an amputation.Three patients (11 per cent) had a problem with union that was treated with augmentation with a bone graft, One patient, who had sustained a refracture, had an amputation, Twenty-five patients (89 per cent) had a total of seventy-one minor or major complications, a rate of 2.5 complications per patient.