摘要目的 探讨抗生素骨水泥联合Ilizarov技术个性化治疗长骨感染性骨缺损的方法和临床疗效。方法 自2011年6月至2017年1月，我院应用Ilizarov技术个性化治疗股骨、胫骨、肱骨骨折术后感染性骨缺损21例，男14例，女7例；年龄18～65岁，平均37岁。其中胫骨骨缺损12例，清创后骨缺损范围平均7.2 cm；股骨骨缺损7例，清创后骨缺损范围平均8.5cm；肱骨骨缺损2例，清创后骨缺损范围平均6 cm。手术分两期进行：一期彻底清创，植入含敏感抗生素骨水泥，采用单边或环形外固定架固定，预留截骨延长的外固定架长度，控制感染；二期感染消灭后，根据Ilizarov技术进行截骨延长。结果 所有患者术后随访12～24个月，平均18.5个月。外固定架固定时间9～21个月，平均17.2个月。外固定架指数(external fixation index，EFI)平均为2.38个月/cm。采用伊里扎洛夫方法研究与应用学会(association for the study and application of the method of Ilizarov，ASAMI)评价标准评价，骨性结果：优13例，良6例，中2例，优良率为90.5%；功能结果：优11例，良7例，中3例，优良率为85.7%。结论 抗生素骨水泥联合Ilizarov技术可有效控制感染，纠正患肢畸形，重建肢体的功能，是治疗长骨感染性骨缺损的有效方法。
Abstract：Objective To discuss the individual-based treatment technique and clinical effects of long bone with infectious bone defects using Ilizarov fixator combined with antibiotic-laden bone cement.Methods From June 2011 to January 2017，21 patients suffered femoral，tibial and humeral infected nonunion with bone defects underwent operation in our hospital.The cases included 14 males and 7 females aged 37(18～65 years).The site of infected nonunion involved 12 tibias，7 femurs and 2 humerus.After debridement，the mean bone defect length of tibia was 7.2cm，the mean bone defect length of femur was 8.5 cm，the mean bone defect length of humerus was 6.0cm.Surgery was performed in two stage.The antibiotic-laden bone cement was implanted to control infection and form a bone-induced membrane after the infected scarred soft tissue and necrotic bone were debrided radically in the primary stage，the affected limb was fixed for bone transport by monolateral external fixator or fixed for bone transport by Ilizarov external fixator.After infection controlled，the bone transport was performed by Ilizarov technology in second stage.Results All the patients were followed up for 12 to 24 months with an average of 18.5 months，the average fixation time was 17.2 months( range from 9 to 21 months)，the mean external fixation index was 2.38 months/cm.Bone results and functional results were evaluated by ASAMI classification.The bone results were excellent in 13 patients，good in 6 patients and fair in 2 patients.Good and excellent rate in bone results was 90.5%.The functional results were excellent in 11 patients，good in 7 patients and fair in 3 patients，good and excellent rate in functional results was 85.7% in our study.Conclusion Our study suggested that Ilizarov fixator combined with antibiotic-laden bone cement can control infection effectively，correct deformity and rebuild limb function，was an effective method of treating long bone with infectious bone defects.
张贵春，郑润泉，邹林，陈晨，郝光亮，曹学成. 抗生素骨水泥联合Ilizarov技术在长骨感染性骨缺损治疗中的应用[J]. 实用骨科杂志, 2019, 25(1): 25-54.
Deng Xiangtian，Liu Juncai，Li Zhong，et al. The Application of Llizarov Fixator Combined with Antibioticladen Bone Cement in Treatment of Infectious Bone Defect of Long Bone. sygkzz, 2019, 25(1): 25-54.
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