生物骨科材料与临床研究2018，Vol.15Issue(1)：13-17,5.DOI:10.3969/j.issn.1672-5972.2018.01.004
一期带蒂组织瓣联合万古霉素骨水泥及颗粒骨治疗小腿创伤后骨髓炎伴骨及软组织缺损
One-stage application of pedicle flap combined with vancomycin cement and granulated bone in treating post-traumatic osteomyelitis of lower leg with bone and soft tissue defect
周炎 1李亚明 1瞿新丛 2明江华 1马永刚 1邓明 1刘世清1
作者信息
- 1. 武汉大学人民医院骨Ⅲ科,湖北 武汉,430060
- 2. 罗田县人民医院骨科,湖北 罗田,438600
- 折叠
摘要
Abstract
Objective To explore the method and clinical effect of one-stage pedicle flap transfer combined with vancomycin cement and granulated bone implantation in treating post-traumatic osteomyelitis of lower leg with bone and soft tissue defect.Methods Between Jun 2008 and Mar 2013,36 cases of post-traumatic osteomyelitis of lower leg with bone and soft tissue defect were treated with one-stage pedicle flap transfer combined with vancomycin cement and granulated bone implantation.There were 25 males and 11 females,with an average age of 46.5 years (from 22 to 60 years).The mean duration was 2.5 months (from 1 to 5 months).The area of soft tissue defect was from 4 cm×5 cm to 13 cm×8 cm,and the average bone defect length was 1.8 cm (from 0.5 cm to 2.5 cm).There were 16 cases underwent vascularised gastrocnemius muscle flap,12 cases of soleus muscle flap,6 cases of sural nerve nutrient vessels myocutaneous flap,2 cases of distal femoral anterolateral myocutaneous flap,at one-stage combined with vancomycin cement and granulated bone implantation,and the surface of muscle flap was repaired by skin graft.Results Thirty-six cases were followed up for 24 ～ 55 months (mean,39.5 months).Two cases suffered distal partial necrosis and healed after debridement dressing and free skin graft.Four cases of wound effusion healed by dressing.Two cases of recurrent infection healed after lesions cleared and lavage drainage.All fractures healed after 6 ～ 21 months (mean,12 months).According to Johner-Wruhs standard assessment at the last follow-up,20 cases were excellent,good in 12 cases,fair in 4 cases,and the excellent and good rate was 88.9％.Conclusion One-stage application ofpedicle flap combined with vancomycin cement and granulated bone in treating post-traumatic osteomyelitis of lower leg with bone and soft tissue defect,is conducive to wound healing,infection control and bone defect repair,which can obtain good clinical curative effect.关键词
创伤性骨髓炎/骨缺损/外科皮瓣/移植/万古霉素/骨水泥Key words
Traumatic osteomyelitis/Bone defect/Surgical flap/Transplantation/Vancomycin/Cement分类
医药卫生引用本文复制引用
周炎,李亚明,瞿新丛,明江华,马永刚,邓明,刘世清..一期带蒂组织瓣联合万古霉素骨水泥及颗粒骨治疗小腿创伤后骨髓炎伴骨及软组织缺损[J].生物骨科材料与临床研究,2018,15(1):13-17,5.
