Application of bone transport with unilateral external fixator combined with locked plate internal fixation in treatment of infected tibial nonunion

目的: 探讨单边外固定支架联合钢板内固定行骨搬运术治疗胫骨感染性骨不连的临床疗效。. Methods: Between January 2010 and December 2014, 23 patients with infected tibial nonunion were treated with bone transport with unilateral external fixator combined with locked plate internal fixation. There were 19 males and 4 females with an average age of 37.8 years (range, 19-54 years). The mean length of the bone defect was 6.5 cm (range, 5.2-8.1 cm). The number of previous operations ranged from 2 to 4 times, with an average of 2.5 times. The time from injury to this treatment was 7-23 months, with an average of 11.8 months. The time of bone transport, time of the external fixation, fracture healing time, external fixation index, healing index, and complication were recorded; and the Association for the Study and Application of the Methods of Ilizarov (ASAMI) bone healing and function scores were used to evaluate the effectiveness. 结果: 23 例患者均获随访，随访时间 3～6 年，平均 4.8 年。所有患者创面及骨缺损均愈合，未出现感染复发、骨不连、再骨折、畸形愈合、医源性神经麻痹、膝关节或踝关节僵硬等并发症。5 例出现钉道感染，经局部护理后未出现深部感染。骨搬运时间 65～120 d，平均 75.6 d；外固定时间 75～145 d，平均 97.8 d；骨折愈合时间 4～17 个月，平均 8.7 个月；外固定指数 18～28 d/cm，平均 22.4 d/cm；愈合指数 31～52 d/cm，平均 40.2 d/cm。末次随访时，根据 ASAMI 评价标准，骨愈合达优 15 例、良 8 例，功能达优 18 例、良 5 例，优良率均为 100%。. Conclusion: For infected tibial nonunion, bone transport with unilateral external fixator combined with locked plate internal fixation can reduce the time of external fixation and related complications, with a satisfactory effectiveness.