Purpose To investigate the clinical outcome of induced membrane technique for treatment of post-traumatic tibial osteomyelitis.Methods A retrospective analysis was made on 17 cases of post-traumatic tibial osteomyelitis admitted from August 2011 to October 2012.There were 13 males and 4 females aged 19-67 years (mean,40.9 years).Mean length of bone defect was 6.7 cm (range,2.0-18.5 cm).Surgical treatments were performed including phase Ⅰ surgical debridement and antibiotics-loaded bone cement impregnation to induce a membrane and phase Ⅱ bone defect reconstruction by intramembranous bone grafting.Clinical effect of the treatment was evaluated.Results Bone healing was detected at the 27-month follow-up (range,24-32 months).Radiographic healing was obtained 4-6 months after operation.Two cases of recurrent infection were noted after phase Ⅰ surgery and had another debridement.External fixator proximal pin track infection occurred in one case and infection was controlled by hardware removal and dressing change.There was one case of metal rejection,two function disorders,one clubfoot,and one ankle stiffness.Conclusion Induced membrane technique is effective in the treatment of post-traumatic tibial osteomyelitis,especially in lone bone defect reconstruction,but limb functional complications are worth consideration during treatment.%目的 探讨膜诱导技术治疗胫骨创伤后骨髓炎的临床疗效.方法 回顾性分析2011年8月-2012年10月收治的17例胫骨创伤后骨髓炎患者,其中男13例,女4例;年龄19～67岁,平均40.9岁.Ⅰ期清创后平均骨缺损长度6.7 cm(2.0 ～18.5 cm),在骨缺损处填塞抗生素骨水泥诱导生物膜形成,Ⅱ期在膜内植骨重建骨缺损,观察膜诱导技术治疗胫骨创伤后骨髓炎的临床疗效.结果 17例患者随访24～32个月(平均27个月),均获得临床骨愈合.术后4～6个月均获得影像学骨愈合.其中2例Ⅰ期术后感染复发,再次清创后,1例发生外固定架近端钉道感染,拆除外固定钢板螺钉并局部换药处理后控制感染;2例出现功能障碍,1例足内翻畸形,1例踝关节僵直,1例出现金属排斥反应.结论 膜诱导技术治疗胫骨创伤后骨髓炎可取得良好疗效,尤其在大段骨缺损的修复重建中具有显著的优势.治疗过程中应加强关注患肢功能性并发症的预防.
展开▼
