Ilizarov技术治疗胫骨感染性骨缺损合并马蹄足畸形的临床观察
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1.首都医科大学附属北京康复医院;2.国家康复辅具研究中心附属康复医院

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Clinical observation of Ilizarov technique in the treatment of infected tibial defect with clubfoot deformity
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1.Beijing Rehabilitation Hospital Affiliated to Capital Medical University;2.Rehabilitation Hospital Affiliated to National Reserach Center for Rehabilitation Technical Aids

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    摘要:

    目的 探讨运用Ilizarov技术同期治疗胫骨感染性骨缺损伴马蹄足畸形的可行性及临床疗效。 方法 回顾分析了2013年1月至2020年9月期间收治的45例胫骨感染性骨缺损伴马蹄足畸形病例,通过对Paley骨髓炎愈合评分标准、AOFAS踝-后足系统评分、并发症发生率等指标的临床观察,评价其临床治疗效果,总结经验和不足。结果 45例患者获得随访,平均随访时间(28.6±12.4)月。所有患者骨缺损及截骨处骨质均一期愈合,无复发性感染。骨搬移长度平均(6.7±3.2)cm,骨搬移时间平均(3.2±1.3)月,携带外固定时间平均(20±5.8)月。创面愈合时间平均(36±11.2)天。末次随访时AOFAS踝-后足系统评分为(85.65±10.45)分,较术前(29.32±6.76)分有显著差异(P<0.05)。所有患者依据Paley的评定标准,骨愈合情况评定均为优;功能评定:优38例,良4例,一般3例。治疗过程中,没有严重并发症发生。 结论 采用Ilizarov技术同期治疗骨髓炎、修复骨大段缺损和矫正踝关节跖屈畸形,彻底治愈了骨髓炎、修复了骨与软组织缺损、恢复患肢的长度、矫正了马蹄足畸形,疗效确切、满意。

    Abstract:

    [Objective] To investigate the feasibility and clinical effect of Ilizarov technique in the treatment of infected tibial defect with clubfoot deformity. [Methods] 45 cases of infected tibial defect with clubfoot deformity were analyzed retrospectively from January 2013 to September 2020. Paley's osteomyelitis healing standard, AOFAS ankle-foot system score and complication rate were evaluated and the experience and deficiency were summarized. [Results] 45 patients were followed up. The average follow-up time was (28.6 ± 12.4) months. All patients with bone defects and osteotomies healed in one stage without recurrent infection. The average length of bone transport was (6.7 ± 3.2) cm. The average time of bone transport was (3.2 ± 1.3) months and the average time of external fixation was (20 ± 5.8) months. The average wound healing time was (36 ± 11.2) days. At the last follow-up, the score of AOFAS was (85.65 ± 10.45), which was significantly different from that before operation (29.32 ± 6.76)(p<0.05). According to Paley's criterion, bone union of all patients were excellent. According to the function, 38 patients were excellent, 4 patients were good, and 3 patients were normal. During the course of treatment, no serious complications occurred. [Conclusion] Ilizarov technique could be used to treat osteomyelitis, repair large bone defects and correct plantar flexion deformity of ankle. It has completely cured osteomyelitis, repaired the defect of bone and soft tissue, restored the length of the affected limb, and corrected the clubfoot deformity.

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  • 收稿日期:2022-03-21
  • 最后修改日期:2022-03-21
  • 录用日期:2022-06-30
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