Bone Transport and Bone Lengthening in the Treatment of Long Bone Chronic Osteomyelitis and Infectious Bone Nonunion_West China Medical Journal

Authors：

 BANZhao-nan ^1,2 ,  HUANGFu-guo ² , WANGYing ¹

1. First Department of Orthopedics, the Fifth People's Hospital of Chengdu, Chengdu, Sichuan 611130, P. R. China;
2. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

HUANGFu-guo, Email: huang-f-g@163.com

Keywords：

Chronic osteomyelitis; Infectious nonunion; Ilizarov external fixator; Bone transport; Bone lengthening

DOI：

10.7507/1002-0179.20140273

Video：

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Objective To analyze the clinical efficacy of Ilizarov bone transport and bone lengthening in the treatment of long bone infection and limb shortening, and fracture nonunion caused by infection. Methods We retrospectively analyzed the clinical data of 13 patients with long bone infection, chronic osteomyelitis of the femur and tibia, and infectious bone nonunion, treated with infection focus removal, Ilizarov outer fixation, bone transport and bone lengthening between June 2011 and October 2013. Among the patients, 8 of them had chronic osteomyelitis of the femur and tibia, 4 had infectious bone nonunion, and one had chronic fibula osteomyelitis. Results All the 13 patients had a first-stage healing of the sinus tract and junctions. Among the patients who did the bone transport by themselves after being discharged from hospital, two had nail infections (one was cured after debridement, and the other underwent amputation after re-infection after debridement). One had a re-fracture after the healing of the previous fracture, and was cured by intramedullary nailing. The length of bone transport in these 13 cases ranged from 5 to 13 cm, averaging 7.5 cm. After bone transport, 11 patients had equal length of the lower limbs, and the affected lower limb of the other two patients became shorter than before. No neural function damage occurred in all the patients. Conclusion Ilizarov bone transport and lengthening technique is an effective way to treat infections and bone defect of long bone, and it can improve patients' quality of life greatly.

Citation： BANZhao-nan, HUANGFu-guo, WANGYing. Bone Transport and Bone Lengthening in the Treatment of Long Bone Chronic Osteomyelitis and Infectious Bone Nonunion. West China Medical Journal, 2014, 29(5): 900-903. doi: 10.7507/1002-0179.20140273 Copy

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12.	高质钢. 延长速度对肢体延长术的影响[J]. 中国矫形外科杂志, 1999, 6(9):59-60.
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1. Rodriguez-Merchan EC, Forriol F. Nonunion:general principles and experimental data[J]. Clin Orthop, 2004(419):4-12.
2. 曲龙,秦泗河. 伊利扎洛夫技术中Bone Transport的中文命名商榷[J]. 中华骨科杂志, 2009, 29(3):274.
3. 胥少汀, 葛宝丰, 徐印坎. 实用骨科学[M]. 3版. 北京:人民军医出版社, 2005:1563.
4. 周建旭, 马宪平, 王岭, 等. 骨搬移法配合中药治疗骨髓炎术后骨缺损的临床研究[J]. 中国医药导报, 2009, 6(30):62-65.
5. 曾炳芳, 康庆林. 四肢骨不连外科学[M]. 北京:人民军医出版社, 2010:311-320.
6. 曲龙,施京辉,刘黎亮,等. 骨搬移法治疗骨感染、骨缺损及软组织缺损[J].中华外科杂志, 2004, 42(23):1469.
7. 陈辉,王爱民,沈岳,等.外固定支架骨搬移术对严重感染下肢骨缺损的治疗[J].重庆医学, 2008, 37(17):1961-1963.
8. 许建中, 李起鸿, 周仲安, 等. 感染性骨不连骨缺损的骨外固定治疗[J]. 中华创伤杂志, 1997, 13(3):8-10.
9. Yang L, Nayagam S, Saleh M. Stiffness characteristics and inter-fragmentary displacements with different hybrid external fixators[J]. J Biomech, 2003, 18(2):166-172.
10. 林在俊, 朱振安. 骨延长术治疗下肢骨缺损与骨不连[J]. 国外医学·骨科学分册, 2004, 25(4):218-220.
11. 艾田, 张俊德, 程添栋, 等. 伊里扎诺夫技术修复兔胫骨骨缺损成骨机制的研究[J]. 临床骨科杂志, 2012, 15(2):202-204.
12. 高质钢. 延长速度对肢体延长术的影响[J]. 中国矫形外科杂志, 1999, 6(9):59-60.
13. Li G, Virdis AS, Ashhurst DE, et al. Tissues formed duringdistraction osteogenesis in the rabbit are datermmed by the distractionrate:localizati on of the cells that express the mRNAs and the distribution of types Ⅰand Ⅱ collagens[J]. Cell Bio Int, 2000, 24(1):25-33.
14. 常非, 于庆巍, 刘光耀, 等. 骨延长速度对成骨过程的影响[J]. 中国组织工程研究与临床康复, 2010, 14(39):7268-7272.
15. 王春妹, 舒衡生, 邵珩, 等. 周围神经在缓慢肢体延长中的形态学观察[J]. 中国矫形外科杂志, 2010, 18(18):1554-1558.
16. 张华, 李贵山, 于新民, 等. Ilizarov治疗胫骨慢性骨髓炎27 cm超长骨搬移1例报告[J]. 中国矫形外科杂志, 2012, 20(7):671-672.
17. Li Z, Zhang X, Duan L, et al. Tissues formed during distraction osteogenesis in the rabbit are determined by the distraction rate:localization of the cells that express the mrnas and the distribution of typesⅠ and Ⅱ collagens[J]. Can J Surg, 2009, 52(2):103-111.
18. 袁宇, 舒衡生, 师红立. X线联合超声对肢体延长术的监测价值[J]. 中国临床医学影像杂志, 2011, 22(1):27-30.

West China Medical Journal

Bone Transport and Bone Lengthening in the Treatment of Long Bone Chronic Osteomyelitis and Infectious Bone Nonunion

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