水泥珠和水泥间隔器:说明,技术和临床结果
Govind Shivram Kulkarni1, Sunil Kulkarni2, Sushrut Babhulkar3
1GSK Orthopedic and Trauma Institute.
概括
抗生素涂层指甲 (ACN) 和水泥珠有效地管理骨感染,特别是受感染的非联合体 (INU). 这项研究强调了它们在复杂案件中的实用性,改善了结果和断裂工会率.
科学领域:
- 整形外科手术 整形外科手术
- 传染病管理 传染病管理
- 生物材料在医学中的应用
背景情况:
- 骨感染,尤其是感染性非结合 (INU),在骨科治疗中构成重大挑战.
- 有效的管理需要解决感染,死亡空间,并实现骨折稳定性.
研究的目的:
- 评估抗生素涂覆指甲 (ACN) 和抗生素水泥珠在治疗骨感染中的有效性.
- 评估不同类别的感染性非结合性和严重的开口骨折的结果.
主要方法:
- 133例感染非联合 (INU) 病例根据感染严重程度,间隙大小和变形而分为I型,II型和III型.
- 治疗策略包括使用造型 (I型) 的ACN,使用珠子和外部固定器的ACN (II型),以及Ilizarov方法 (III型).
- 一组28个古斯蒂洛III级开口骨折的子组接受了除bridement,ACN和抗生素珠.
主要成果:
- 133个INU病例的总体结果被分类为优秀,好或差.
- I型INU显示出高率的优秀/良好的结果. 类型IIINU的结果分别为39%优秀,43%好,18%差,其中感染和硬度是关键问题.
- 在68例中实现了骨折结合;然而,在28例接受治疗的开口骨折中,有4例患有感染的非结合,由于膝盖硬而功能不佳.
结论:
- 抗生素浸的水泥钉 (ACN) 有效地填补死空间,并提供机械稳定性,同时消除抗生素.
- 建议使用ACN作为管理感染非联合体 (INU) 的辅助.
- ACN在精选的Gustilo III级开口骨折中显示出希望,尽管需要仔细监测诸如膝盖硬等并发症.
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