胫腓骨感染性骨缺损治疗的研究现状△

Current research on treatment of infected tibiofibular bone defects

摘要:

骨缺损常由高能量损伤、开放性损伤合并感染、骨原发、继发性肿瘤、骨髓炎手术清创、先天性骨骼发育异常等导致。随着人类社会进步和人民生活水平不断提高，小腿复杂开放性骨折患者也呈逐年增多趋势。因胫腓骨特殊的解剖位置及特征，外伤性、开放性粉碎性骨折，导致胫腓骨骨缺损在骨缺损病例中占较大比例。而复杂开放性胫腓骨骨折，传统治疗方法为一期严格清创复位，二期行植骨、内/外固定治疗，由于创面污染较重、软组织坏死缺损，后期易进展为感染性骨缺损。目前，对于胫腓骨感染性骨缺损治疗方式有许多种，但各技术均有利弊。本文拟对国内外胫腓骨感染性骨缺损治疗研究现状作一综述，为临床医生采用适当的治疗方法处理胫腓骨感染性骨缺损提供参考，最大程度有益于患者治疗，减轻患者病痛。

Abstract:

Bone defects are often caused by high-energy injury, open injury combined with infection, primary and secondary bone tu-mors, surgical debridement of osteomyelitis, and congenital skeletal dysplasia. With the progress of human society and the continuous im-provement of people's living standards, the number of patients with complex open fracture of the lower leg is also increasing year by year.Due to the special anatomical position and characteristics of the tibia and fibula, traumatic and open comminuted fractures lead to bone de-fects of the tibia and fibula, which account for a large proportion of bone defects. However, the traditional treatment for complex open tibiaand fibula fractures is strict debridement and fracture reduction in the first stage, and bone grafting and internal or external fixation in thesecond stage. Due to heavy wound contamination and soft tissue defect, it is prone to be infectious bone defect in the later stage. At present,there are many treatment methods for infected tibiofibular bone defects, but each technique has advantages and disadvantages. This articleaims to review the current research status of treatment of infected tibiofibular bone defects at home and abroad, so as to provide a necessaryreference for clinicians to handle the infected tibiofibular bone defects in the proper ways, which is beneficial to the patients to the greatestextent and reduce the pain of patients.