Masquelet技术结合En bloc切除治疗Cierny-MaderⅣB型骨髓炎的疗效分析

Abstract
Figure/Table
References
Related Citation (0)

Download: PDF (2790 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the therapeutic effect of Masquelet technique combined with en bloc resection on Cierny-Mader IV B osteomyelitis. Methods A retrospective study was performed on 8 cases of lower extremity osteomyelitis admitted from June 2017 to June 2021, with 5 male and 3 female patients. The age of the patient was 21-67 years old, the average age was (43.8±23.4） old, and the defect site was 1 case of femoral shaft, 6 cases of tibial shaft, and 1 case of calcaneus; Cierny-Mader classification selects type IV. B. Masquelet technology is combined with en bloc for staged treatment. Observe the patient's infection healing, bone and wound covering soft tissue healing, limb functional activities and complications. Results Eight patients were followed up for 6-18 months after surgery, and no recurrence was found during the follow-up. When the patient last reviewed inflammatory indicators, the data remained normal, such as white blood cells, PCT, CRP, etc. The two groups of data were compared before and after surgery, and the results were statistically significant. Infection clearance 100% (8/8). All patients were able to heal the fracture and the soft tissue covered by the wound 5-8 months after the operation, the average duration was (6.1±1.2) months, and finally be able to walk independently. The joint function of the 8 patients recovered well after surgery, and all of them had no complications. Conclusion Masquelet technique combined with en bloc resection can clear infection, promote the healing of fractures and wound covered soft tissues and restore limb function, and is a simple and effective method for the treatment of bone defects in Cierny-Mader IV B osteomyelitis.

Key words： masquelet technology bones of lower extremity osteomyelitis bone remodeling

Received: 07 April 2023

PACS:

R681.2

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	PENG Qianbao
	HE Weixin
	LI Yuan
	ZHONG Haiyan
	LIU Rushi
	XU Zili

Cite this article:

PENG Qianbao,HE Weixin,LI Yuan等. Efficacy analysis of Masquelet technique combined with En bloc excision in the treatment of Cierny-Mader type IV B osteomyelitis[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(4): 36-42.

URL:

http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I4/36

[1] 余斌, 张英泽, 唐佩福, 等. 中国骨折内固定术后感染诊断与治疗专家共识 (2018版)[J]. 中华创伤骨科杂志, 2018, 20(11): 929-936.
[2] 王刚, 章乐成, 严超, 等. Ilizarov 技术结合载万古霉素骨水泥治疗胫骨创伤后骨感染合并骨与软组织缺损的疗效[J]. 中华创伤杂志, 2021, 37(03): 210-215.
[3] Wang X, Wang Z, Fu J, et al.Induced membrane technique for the treatment of chronic hematogenous tibia osteomyelitis[J]. BMC Musculoskelet Disord, 2017, 18(1): 33.
[4] Lê Thua TH, Boeckx WO, Zirak C, et al.Free intra-osseous muscle transfer for treatment of chronic os-teomyelitis[J ]. J Plast Surg Hand Surg, 2015, 49(5): 1.
[5] Cierny G 3rd, Mader J, Penninck J. A clinical staging system for adult osteomyelitis[J]. Clin Orthop Relat Res, 2003, 2003(414): 7-24.
[6] 吴宏日, 贾硕, 傅景曙, 等. En bloc切除结合膜诱导技术分期治疗长骨Cierny-Mader Ⅳ型创伤后骨感染[J]. 中华创伤杂志, 2017, 33(02): 147-152.
[7] Parsons P, Strauss E.Surgical management of chronic osteomyelitis[J]. Am J Surg, 2004, 188(1A Suppl): 57-66.
[8] 孙川, 刘冰川, 侯国进, 等.3D打印修复联合Masquelet技术治疗Cierny-Mader Ⅳ型长骨骨髓炎骨缺损的疗效分析[J]. 中华创伤骨科杂志, 2021, 23(01): 68-74.
[9] 邸佳琛, 李文波, 时培晟, 等. 慢性骨髓炎抗生素应用疗程的研究进展[J]. 中华创伤骨科杂志, 2022, 24(02): 173-178.
[10] Taylor BC, Hancock J, Zitzke R, et al.Treatment of bone loss with the induced membrane technique: techniques and outcomes[J]. J Orthop Trauma, 2015, 29(12): 554-557.
[11] Mauffrey C, Hake ME, Chadayammuri V, et a1. Reconstruction of long bone infections using the induced membrane technique: tips and tricks[J]. J Orthop Trauma, 2016, 30(6): e188-193.
[12] Masquelet AC, Begue T.The concept of induced membrane for reconstruction of long bone defects[J]. Orthop Clin NoAh Am, 2010, 41(1): 27-37.
[13] 姜楠, 余斌. 骨折内固定术后感染的诊治最新进展[J]. 中华创伤骨科杂志, 2020, 22(12): 1098-1104.
[14] 杨孝灿, 丁海生, 焦生辉, 等. 术后交替常、负压引流和抗生素冲洗治疗慢性骨髓炎[J]. 现代中西医结合杂志, 2013, 22(36): 4041-4043.
[15] 张震, 魏屹东, 季明华, 等. 胫骨慢性骨髓炎治疗进展[J]. 实用骨科杂志, 2019, 25(02): 146-149.
[16] Metsemakers WJ, Kuehl R, Moriarty TF, et al. Infection after fracture fixation: current surgical and microbiological concepts[J]. Injury, 2018, 49(3): 5ll-522.
[17] Wu X, Kubilay NZ, Ren J, et a1. Antimicrobial-coated sutures to decrease surgical site infections: a systematic review and meta-analysis[J]. Eur J Clin Microbiol Infect Dis, 2017, 36(1): 19-32.
[18] Eckardt J, Wirganowicz P, Mar T.An aggressive surgical approach to the management of chronic osteomyelitis[J]. Clin Orthop Relat Res, 1994, (298): 229-239.
[19] Marais L, Ferreira N.Bone transport through an induced membrane In the management of tibial bone defects resulting from chronic osteomyelitis[J]. Strategies Trauma Limb Reconstr, 2015, 10(1): 27—33.
[20] Penner MJ, Masri BA, Duncan CP. Elution characteristics of vancomycin and tobramycin combined in acrylic bone—cement[J]. J Arthroplasty, 1996, 1 1(8): 939-944.