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目的 探索小儿慢性骨髓炎大段死骨早期摘除后骨缺损的Ⅰ期修复效果。方法 16例胫骨慢性骨髓炎并大段死骨清除后 ,作吻合血管腓骨移植Ⅰ期重建 ;2例作炎性骨段切除 ,采用带血管蒂腓骨移位Ⅰ期修复。结果 18例胫骨慢性骨髓炎在摘除大段死骨后 ,应用吻合血管腓骨移植或带血管蒂腓骨移植重建。术后平均随访 2 6个月 ,见重建骨完全骨性愈合 ,累及的炎症得到完全控制 ;修复肢体的功能、外形令人满意。结论 慢性骨髓炎所形成的大段死骨在作病灶清除的同时 ,进行早期的血管吻合或带血管腓骨移植Ⅰ期重建术 ,可免除死骨爬行替代的漫长病程 ,改善受区血液循环 ,抑制炎症漫延 ,缩短了住院时间 ,减少手术次数。为骨髓炎早期死骨清除骨缺损的重建提供了有效外科治疗手段
Objective To explore the first stage repair effect of bone defect in early stage of chronic osteomyelitis in children with chronic osteomyelitis. Methods Sixteen patients with chronic osteomyelitis of the tibia and large necrotic bone were resected for stage Ⅰ reconstruction of anastomosed vascularized fibula. Two cases were treated with inflammatory osteotomy and the first stage was repaired with vascularized fibular transposition. Results Eighteen patients with chronic osteomyelitis of the tibia were treated with anastomosis of fibular graft or vascularized fibular graft after the removal of large sequestrum. After an average follow-up of 26 months, see the complete reconstruction of bone healing, the inflammation involved was completely controlled; repair limb function, appearance is satisfactory. Conclusions The large segment of sequestrum formed by chronic osteomyelitis can be used for the first stage reconstruction of vascular anastomosis or fibular fibular graft, which can eliminate the long course of sequestrum replacement and improve blood circulation of the affected area, Spread of inflammation, shorten the hospital stay, reduce the number of operations. It provides an effective means of surgical treatment for reconstructing bone defects of osteosarcoma at the early stage