摘要:
目的：探索扩大碟形术加带血管蒂腓骨游离移植治疗胫骨慢性骨髓炎的可行性和疗效。方法：12例胫骨慢性骨髓炎患者行胫骨骨髓炎病灶清除、扩大碟形术，取对侧带血管蒂腓骨游离移植，修复患侧胫骨切除后缺损，置冲洗引流管。结果：经2~3年随访，优5例，良6例，中1例，绝大部分病例胫骨碟形化部经重建修复后在13~18月内满意愈合，恢复行走功能，少部分病例术后切口有轻微感染。经随访发现，随着骨缺损部逐渐愈合，移植来的腓骨会逐渐塑形、增粗，并与受区胫骨融为一体。结论：扩大碟形术加带血管蒂腓骨游离移植治疗胫骨慢性骨髓炎具有可行性和较满意之疗效，强调骨髓炎手术适应症的正确把握和感染病灶清除的适当彻底，须注意围手术期全程的规范化管理。
To explore the availability and curative effect of the reconstruction through enlarging sauceriza-tion and Fibula Transplantation with Vascular (FTV) in the cases of chronic tibia osteomyelitis. Methods: Altogether 12 cases of chronic tibia osteomyelitis were treated by massive resection of bone, enlarging saucerization and tibia defects were reconstructed by opposite FTV. Douche and drainage-tube were inserted after operation. Results: The follow-up ranged from 2 to 3 years. Excellent results were obtained in 5 cases, good in 6, fair in 1 case. Mainly cases with tibia enlarging saucerization defects treated by reconstructive repairment were unioned satisfactory after 13 - 18 months. Walk functions were recovered. A few cases were slightly infected in wound. Observing in followed, during the union of bone defects, (ftv) fibula was plastotyped strongly and the fibula and tibia were unioned totally. Conclusions: To treat the chronic tibia osteomyelitis by enlarging saucerization and Free Fibula transplantation with vascular (FTV) should be attached feasible and satisfactory curative effect. To emphasize grasping the operation indication rightly, and the infect focus debridement were cleared suitable thoroughly. The standard administration in whole course of operation should be paid attention.