腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入治疗胫骨慢性骨髓炎的疗效分析

Efficacy of implantation of sural nerve nutritional vessel flap combined with Vancomycin sulfate calcium bone cement for treatment of chronic tibial osteomyelitis

摘要:

目的  探讨腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入治疗胫骨慢性骨髓炎的临床疗效。方法  2013年2月-2014年2月，哈尔滨市第一医院30例胫骨慢性骨髓炎患者，给予封闭式负压引流（VSD）、腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入治疗，平均随访12个月。观察治疗的临床疗效、皮瓣修复情况及骨折愈合情况。结果  临床疗效评估显示，其中，19例优、10例良、1例差，优良率为96.7%。平均随访12个月，皮瓣与周围皮肤色泽相似，皮瓣血运好，无肿胀，骨折均达到骨性愈合。结论  腓肠神经营养血管皮瓣联合万古霉素硫酸钙骨水泥植入治疗胫骨慢性骨髓炎的疗效显著，尤其适用于伴软组织缺损的胫骨慢性骨髓炎。

Abstract:

Objective To study the clinical efficacy of implantation of sural nerve nutritional vessel flap combined with Vancomycin sulfate calcium bone cement for treatment of chronic tibial osteomyelitis. Methods Thirty patients with chronic tibial osteomyelitis in our hospital from Feb. 2013 to Feb. 2014 were treated with vaccum sealing drainage (VSD) and implantation treatment of sural nerve nutritional vessel flap combined with Vancomycin sulfate calcium bone cement. The clinical efficacy, flap repair and fracture healing were observed on the average follow-up of 12 months. Results The clinical efficacy evaluation of the treatment showed that 19 cases were excellent, 10 cases were good and 1 case was poor, and the excellent and good rate was 96.7%. The flap and surrounding skin color was similar, the blood supply of the flap was good without swelling, and all the fractures obtained bony union. Conclusions The implantation of sural nerve nutrition vessel flap combined with Vancomycin sulfate calcium bone cement has significant efficacy in the treatment of chronic tibial osteomyelitis, especially suitable for that with soft tissue defect.