中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2013年
33期
1-3,4
,共4页
Masquelet技术%感染%骨缺损%骨修复
Masquelet技術%感染%骨缺損%骨脩複
Masquelet기술%감염%골결손%골수복
Masquelet technique%Infection%Bone defect%Bone repair
目的：探讨Masquelet技术在修复感染性指(掌)骨大段骨缺损中的临床应用及疗效。方法：自2008年1月-2013年1月，感染性指(掌)骨大段骨缺损患者应用Masquelet技术，结合或不结合皮瓣修复指(掌)骨大段骨缺损21例。21例患者均为一期清创或内固定手术后感染，其中金黄色葡萄球菌感染者13例，链球菌7例，铜绿假单胞菌感染者1例。应用Masquelet技术，一期手术彻底清创后抗生素骨水泥占位填充骨缺损，6~8周后二期手术取出骨水泥，置入自体松质骨，修复骨缺损长度为11~33 mm，平均19 mm。结果：21例中手术成功20例，1例失败，原因为拇指近节指骨一期手术术后再次感染，后行再次清创、拇指短缩、关节融合术。手术成功者18例获得随访，失访2例。随访时间平均7个月。18例感染性指(掌)骨缺损患者中食指侧方皮瓣覆盖者3例，术后创面一期愈合18例，愈合时间10~15 d，二期手术后骨愈合时间2.6~3.5个月，平均愈合时间2.8个月，患指功能恢复满意。结论：Masquelet技术在修复感染性指(掌)骨大段骨缺损中效果良好。
目的：探討Masquelet技術在脩複感染性指(掌)骨大段骨缺損中的臨床應用及療效。方法：自2008年1月-2013年1月，感染性指(掌)骨大段骨缺損患者應用Masquelet技術，結閤或不結閤皮瓣脩複指(掌)骨大段骨缺損21例。21例患者均為一期清創或內固定手術後感染，其中金黃色葡萄毬菌感染者13例，鏈毬菌7例，銅綠假單胞菌感染者1例。應用Masquelet技術，一期手術徹底清創後抗生素骨水泥佔位填充骨缺損，6~8週後二期手術取齣骨水泥，置入自體鬆質骨，脩複骨缺損長度為11~33 mm，平均19 mm。結果：21例中手術成功20例，1例失敗，原因為拇指近節指骨一期手術術後再次感染，後行再次清創、拇指短縮、關節融閤術。手術成功者18例穫得隨訪，失訪2例。隨訪時間平均7箇月。18例感染性指(掌)骨缺損患者中食指側方皮瓣覆蓋者3例，術後創麵一期愈閤18例，愈閤時間10~15 d，二期手術後骨愈閤時間2.6~3.5箇月，平均愈閤時間2.8箇月，患指功能恢複滿意。結論：Masquelet技術在脩複感染性指(掌)骨大段骨缺損中效果良好。
목적：탐토Masquelet기술재수복감염성지(장)골대단골결손중적림상응용급료효。방법：자2008년1월-2013년1월，감염성지(장)골대단골결손환자응용Masquelet기술，결합혹불결합피판수복지(장)골대단골결손21례。21례환자균위일기청창혹내고정수술후감염，기중금황색포도구균감염자13례，련구균7례，동록가단포균감염자1례。응용Masquelet기술，일기수술철저청창후항생소골수니점위전충골결손，6~8주후이기수술취출골수니，치입자체송질골，수복골결손장도위11~33 mm，평균19 mm。결과：21례중수술성공20례，1례실패，원인위무지근절지골일기수술술후재차감염，후행재차청창、무지단축、관절융합술。수술성공자18례획득수방，실방2례。수방시간평균7개월。18례감염성지(장)골결손환자중식지측방피판복개자3례，술후창면일기유합18례，유합시간10~15 d，이기수술후골유합시간2.6~3.5개월，평균유합시간2.8개월，환지공능회복만의。결론：Masquelet기술재수복감염성지(장)골대단골결손중효과량호。
Objective:To study effect of large segmental bone defects of phalanges(metacarpal) with Masquelet technique.Method:From January 2008 to January 2013,21 cases were therapied by Masquelet technique,with skin flap or not.All cases were infected after a debridement or internal fixation,including 13 cases of Staphylococcus aureus infection,7 cases of streptococcal infection,and 1 case of Pseudomonas aeruginosa infection.Masquelet technique involved a two-step procedure.First,bone cement was used to fill the bone defect after a thorough debridement;then the bone cement was removed after 6-8 weeks,and rich cancellous bone was implanted into the bone defect.Repairing the length of bone defect was vary from 11 mm to 33 mm(average 19 mm).Result:20 cases were cured with the clinical application of Masquelet technique,1 case was failed,due to an re-infection after the first surgery,then underwent debridement, thumb shortening and arthrodesis.18 cases were followed up,2 cases were lost.The average follow-up times were 7 months.In the 18 cases,3 cases of bone defect fingers were repaired with side flap,18 cases of wound skin were healing in 10 to 15 days,bone healing times were from 2.6 to 3.5 months(average 2.8 months), the recovery of function in fingers were all satisfactory.Conclusion:Masquelet technique is an effective method to repair large segmental infective phalanges or metacarpal defects.
