Clinical efficacy of bone transport technique in treatment of large segment infective nonunion of femoral shaft
10.3760/cma.j.issn.1001-8050.2018.11.011
- VernacularTitle:骨搬移技术治疗股骨干大段感染性骨不连的疗效
- Author:
Yanfeng ZHU
1
;
Jian YU
;
Wei ZHANG
;
Xiang CUI
;
Zhuo ZHANG
;
Lihai ZHANG
;
Peifu TANG
;
Qun ZHANG
Author Information
1. 河北省中医院骨一科
- Keywords:
Femur fractures;
Infection;
Ilizarov technique;
Fracture,ununited
- From:
Chinese Journal of Trauma
2018;34(11):1014-1019
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical effect of bone transport technique in the treatment of large segment infective nonunion of femoral shaft.Methods A retrospective case series study was conducted to analyze the clinical data of 33 patients with large segment infective nonunion of femoral shaft admitted to Chinese PLA General Hospital from June 2012 to October 2015.There were 25 males and eight females,aged 19-58 years (mean,34.6 years).In terms of the initial injury,23 patients were with open fracture and 10 with closed fracture.All patients previously received 1-9 times of operation,with an average of 2.3 times.The duration from injury to operation ranged from 7-60 months,with an average of 34 months.All patients underwent treatment with bone transport technique.After thorough debridement,the length of femoral defect ranged from 6 cm to 18 ema,with an average of 10.5 cm.The single arm limb reconstruction external fixator was placed on the lateral side of the femur under C-ann X-ray fluoroscopy.The wound healing,bone healing time,external fixation index (EFI),and complications were recorded.The function of the affected limb was evaluated using the modified criteria of Association for the Study and Application of the Method of Ilizarov (ASAMI).Results All patients were followed up for 21-53 months (average,38.5 months).Femoral defects were completely repaired,with no recurrent infection reported.Bone healing time ranged from 8 months to 25 months (average,13 months).The external fixation index (EFI) ranged from 1.13 months/cm to 1.83 months/cm,with an average of 1.26 months/cm.The infection rate of the nail tract was 55％ (18/33).There were 12 patients with Type A,five with Type B,and one with Type C.The function of the affected limb was graded as excellent in 18 patients,good in six,fair in five,and poor in four,with an excellent and good rate of 73％ (24/33).Conclusions In the treatment of large segment infective nonunion of femoral shaft,bone transport technique can eontrol the infection,promote defect repair,and restore the function of affected limbs.
