创伤外科杂志
創傷外科雜誌
창상외과잡지
JOURNAL OF AUMATIC SURGERY
2015年
3期
225-228
,共4页
扈克治%龚震宇%甘干达%罗平%冯小艳%韩健%谢小军
扈剋治%龔震宇%甘榦達%囉平%馮小豔%韓健%謝小軍
호극치%공진우%감간체%라평%풍소염%한건%사소군
胫骨%骨缺损%软组织缺损%Ilizarov技术%VSD技术%外固定
脛骨%骨缺損%軟組織缺損%Ilizarov技術%VSD技術%外固定
경골%골결손%연조직결손%Ilizarov기술%VSD기술%외고정
tibia%bone defect%soft tissue defect%Ilizarov technique%VSD technique%external fixation
目的:探讨Ilizarov技术及VSD技术联合使用在治疗合并软组织缺损的胫骨干骨缺损中的临床应用效果。方法选择2011年2月~2014年7月收治的合并软组织缺损的胫骨干骨缺损患者28例,男性18例,女性10例;年龄13~62岁,平均37.6岁。骨缺损长度2.5~10.8cm,平均6.7cm,软组织缺损面积(1.5cm ×3.5cm~4.5cm ×8.8cm,平均2.7cm ×6.4cm)。一期清创,清除感染及粉碎严重的骨质,胫骨干骺端截骨,安装Ilizarov外固定架,VSD护创材料覆盖创面,术后1周行皮肤及骨组织同时推移。结果所有患者随访5~23个月,平均15个月。骨缺损均得以重建并骨性愈合,患侧肢体长度与健侧之差<1.5cm,创面均愈合。外固定指数1.3~2.5个月/cm,平均2.05个月/cm。结论联合Ilizarov及VSD技术治疗合并软组织缺损的胫骨干骨缺损疗效满意,实现了骨与软组织缺损的同期治疗。
目的:探討Ilizarov技術及VSD技術聯閤使用在治療閤併軟組織缺損的脛骨榦骨缺損中的臨床應用效果。方法選擇2011年2月~2014年7月收治的閤併軟組織缺損的脛骨榦骨缺損患者28例,男性18例,女性10例;年齡13~62歲,平均37.6歲。骨缺損長度2.5~10.8cm,平均6.7cm,軟組織缺損麵積(1.5cm ×3.5cm~4.5cm ×8.8cm,平均2.7cm ×6.4cm)。一期清創,清除感染及粉碎嚴重的骨質,脛骨榦骺耑截骨,安裝Ilizarov外固定架,VSD護創材料覆蓋創麵,術後1週行皮膚及骨組織同時推移。結果所有患者隨訪5~23箇月,平均15箇月。骨缺損均得以重建併骨性愈閤,患側肢體長度與健側之差<1.5cm,創麵均愈閤。外固定指數1.3~2.5箇月/cm,平均2.05箇月/cm。結論聯閤Ilizarov及VSD技術治療閤併軟組織缺損的脛骨榦骨缺損療效滿意,實現瞭骨與軟組織缺損的同期治療。
목적:탐토Ilizarov기술급VSD기술연합사용재치료합병연조직결손적경골간골결손중적림상응용효과。방법선택2011년2월~2014년7월수치적합병연조직결손적경골간골결손환자28례,남성18례,녀성10례;년령13~62세,평균37.6세。골결손장도2.5~10.8cm,평균6.7cm,연조직결손면적(1.5cm ×3.5cm~4.5cm ×8.8cm,평균2.7cm ×6.4cm)。일기청창,청제감염급분쇄엄중적골질,경골간후단절골,안장Ilizarov외고정가,VSD호창재료복개창면,술후1주행피부급골조직동시추이。결과소유환자수방5~23개월,평균15개월。골결손균득이중건병골성유합,환측지체장도여건측지차<1.5cm,창면균유합。외고정지수1.3~2.5개월/cm,평균2.05개월/cm。결론연합Ilizarov급VSD기술치료합병연조직결손적경골간골결손료효만의,실현료골여연조직결손적동기치료。
Objective To investigate the effect of Ilizarov and VSD technique in the treatment of tibial bone defect combined with soft tissue defect.Methods A total of 28 patients(18 males and 10 females aged from 13-62 years with an average of 37.6 years) with tibial bone defect combined with soft tissue defect were fixed with Ilizarov and VSD technique from Feb.2011 to Jul.2014.The length of bone defect was 2.5-10.8 cm ( average, 6.7cm) and the soft tissue defect areas ranged from 1.5cm ×3.5cm to 4.5cm ×8.8cm(average,2.7cm ×6.4cm). Thorough debridement of the bone defects was completed. Infected and severely crushed bone chips were cleared and metaphyseal tibial osteotomy was performed.External fixation was made with Ilizarov external fixator.VSD ma-terial was employed to cover the wound.Bone and soft tissue infection and defect were treated at the same time. Results All patients were followed up for an average of 15 months(5-23months),which showed reconstruction of the bone defects and restoration of the limb length were achieved( fracture healing was acquired and the length differ-ence was less than 1.5 cm).External fixation index was from 1.3 month/cm to 2.5 month/cm( average,2.05 month/cm) .Conclusion Ilizarov combined with VSD technique has good effect in the treatment of tibial bone de-fect combined with soft tissue defect,which simultaneously achieved the treatment of bone and soft tissue defects.