清创一期植骨及腓肠神经皮瓣治疗跟骨慢性骨髓炎伴软组织缺损

doi:10.3969/j.issn.1009-976X.2013.01.019

岭南现代临床外科 ›› 2013, Vol. 13 ›› Issue (01): 62-64.DOI: 10.3969/j.issn.1009-976X.2013.01.019

清创一期植骨及腓肠神经皮瓣治疗跟骨慢性骨髓炎伴软组织缺损

陈添¹,侯念宗²,宋卫东³,陈皓⁴,刘文宙³,陈炳豪³,阿迪³

1. 湛江市第二人民医院
2. 中山孙逸仙纪念医院
3. 中山大学孙逸仙纪念医院
4. 济宁市人民医院

通讯作者: 侯念宗
基金资助:
骨髓间质干细胞通过RANK/RANKL/OPG轴促进糖尿病神经病变大鼠骨愈合中作用机理研究

Efficacy of debridement and one-stage bone grafting combined with sural neurotropic skin flap transplantation on the treatment of chronic calcaneal osteomyelitis associated with soft tissue defect

Chen Tian, Hou Nianzong, Chen Hao, Liu Wenzhou, Chen Binghao, Anand A, Song Weidong

Sun Yat-sen Memorial Hospital, Sun Yat-sen University

Received:2012-10-30 Revised:2012-12-11 Online:2013-02-20 Published:2013-02-18
Supported by:
The research of mechanism of MSC on bone healing in diabetic neuropathic rat model through RANK/RANKL/OPG axis

摘要/Abstract

摘要：

【摘要】目的 探讨清创、一期植骨联合腓肠神经皮瓣移植治疗跟骨慢性骨髓炎伴软组织缺损的疗效。方法 2008年11月~2011年11月,对 12例合并软组织缺损的跟骨慢性骨髓炎患者采用清创、一期植骨联合腓肠神经皮瓣移植修复创面,观察术后皮瓣成活、骨髓炎治愈及踝关节功能情况。结果术后随访9~24个月,平均 17个月。9例皮瓣Ⅰ期愈合,3例窦道形成或边缘坏死经处理后愈合;随访期间无骨髓炎复发;根据美国足踝外科协会(AOFAS ) 踝后足功能评分术后(89.4±7.8)较术前(42.8±15.3)明显提高,差异有统计学意义(P<0.05)。结论跟骨慢性髓炎合并软组织缺损通过彻底清创、一期植骨及腓肠神皮瓣移植取得良好的效果,该方法具有疗效确切、疗程短、简单易行等特点。

关键词: 跟骨;骨髓炎, 清创, 自体骨, 腓肠神经营养皮瓣, AOFAS踝后足评分

Abstract:

【Abstract】Objective To investigate the efficacy of debridement and autogenous cancellous bone combined with sural neurotropic skin flap transplantation on the treatment of chronic calcaneal osteomyelitis complicated with soft tissue defect. Methods From November 2008 to November 2011, 12 patients of chronic calcaneal osteomyelitis with soft tissue defects were treated with debridement and autogenous cancellous bone combined with sural neurotropic skin flap transplantation in one-stage operation. And postoperative survival condition of flaps, recurrence of the osteomyelitis or not and the function of ankle were followed up. Results The patients were followed up for 9-24 months (an average of 17 months), of which 9 cases were healed by first intension and 3 cases sinus formation or flap edge necrosis were second intension following corresponding treatment. During follow-up periods, no patients with osteomyelitis recurrenced. According to the AOFAS scores of ankle-foot function, the excellent, good and fair were in 9, 2 and 1 case respectively. Conclusion Chronic calcaneal osteomyelitis associated with soft tissue defect can achieve good outcome through debridement and autogenous cancellous bone combined with sural neurotropic skin flap transplantation and this method has the advantage such as obvious curative effect, short therapeutic course and simple procedures.

Key words: Calcaneus, Osteomyelitis, Debridement, Autogenous bone, Sural neurotropic skin flap, AOFAS scores

中图分类号:

R686

陈添侯念宗宋卫东陈皓刘文宙陈炳豪阿迪. 清创一期植骨及腓肠神经皮瓣治疗跟骨慢性骨髓炎伴软组织缺损[J]. 岭南现代临床外科, 2013, 13(01): 62-64.

Chen Tian, Hou Nianzong, Chen Hao, Liu Wenzhou, Chen Binghao, Anand A, Song W.D.. Efficacy of debridement and one-stage bone grafting combined with sural neurotropic skin flap transplantation on the treatment of chronic calcaneal osteomyelitis associated with soft tissue defect[J]. Lingnan Modern Clinics in Surgery, 2013, 13(01): 62-64.

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清创一期植骨及腓肠神经皮瓣治疗跟骨慢性骨髓炎伴软组织缺损

Efficacy of debridement and one-stage bone grafting combined with sural neurotropic skin flap transplantation on the treatment of chronic calcaneal osteomyelitis associated with soft tissue defect

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