抗生素骨水泥被覆重建钢板治疗感染性骨盆前环骨折
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作者Author单位AddressE-Mail
厉孟 LI Meng 甘肃省人民医院骨三科, 甘肃 兰州 730099 The Third Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730099, Gansu, China 1310348961@qq.com 
王克竞 WANG Ke-jing 甘肃省人民医院骨三科, 甘肃 兰州 730099 The Third Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730099, Gansu, China  
高振洋 GAO Zhen-yang 甘肃省人民医院骨三科, 甘肃 兰州 730099 The Third Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730099, Gansu, China  
谢云飞 XIE Yun-fei 甘肃省人民医院骨三科, 甘肃 兰州 730099 The Third Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730099, Gansu, China  
郭涛 GUO Tao 甘肃省人民医院骨三科, 甘肃 兰州 730099 The Third Department of Orthopaedics, Gansu Provincial People's Hospital, Lanzhou 730099, Gansu, China  
期刊信息:《中国骨伤》2024年,第37卷,第5期,第451-457页
DOI:10.12200/j.issn.1003-0034.20230926
基金项目:甘肃省人民医院院内科研基金项目(编号:2019-258)
中文摘要:

目的:探讨抗生素骨水泥被覆重建钢板治疗感染性骨盆前环骨折的临床疗效。

方法:自2017年1月至2022年3月应用抗生素骨水泥被覆重建钢板治疗感染性骨盆前环骨折患者11例,男7例,女4例;年龄27~49岁;骨盆骨折Tile分型:C1型4例,C2型4例,C3型3例。2例前环内固定术后感染,9例患者均因早期清创不彻底导致前环感染,按创伤严重度评分标准(injury severity score,ISS)评分为24~38分。前环经扩大清创、冲洗、抗生素骨水泥被覆重建钢板内固定,后环骨折均采用闭合复位,骶髂螺钉内固定。

结果:11例均获得随访,时间13~20个月。2例术后感染复发,1例经再次清创更换抗生素骨水泥涂层内固定,1例感染较轻,未累计髓腔,清创后保留钢板仅更换抗生素骨水泥,感染得到控制。2例出现切口渗液,术后3个月取出内固定后愈合。所有患者在随访期内未见骨盆骨折再移位、再发感染。最终11例均骨性愈合。末次随访,按照Matta骨折复位标准,优6例,良4例,可1例;按照Majeed功能评分,优6例,良3例,可2例。

结论:抗生素骨水泥被覆重建钢板有效治疗感染性骨盆前环骨折,具有术中安全性高和感染复发率低的特点,有利于术后早期康复锻炼,明显缩短病程。
【关键词】骨盆骨折  内固定  感染  抗生素骨水泥
 
Antibiotic bone cement covered reconstruction plate for infected anterior pelvic ring fractures
ABSTRACT  

Objective To explore the clinical efficacy of antibiotic bone cement covered reconstruction steel plate in the treatment of infected anterior pelvic ring fracture.

Methods From January 2017 to March 2022,11 patients with infected anterior pelvic ring fracture were treated with antibiotic bone cement covered reconstruction steel plate including 7 males and 4 females and the age ranged from 27 to 49 years old. The pelvic fractures were classified according to the Tile typology:4 cases of C1 type,4 cases of C2 type,and 3 cases of C3 type. Among them,2 cases of infected anterior ring were infected after internal fixation of anterior ring,and 9 patients were infected with infected anterior ring due to incomplete early debridement,which was classified as infected according to the injury severity score(ISS) for 24 to 38 scores. The anterior ring was internally fixed by extended debridement,irrigation,and antibiotic bone cement covered reconstruction plate,and the posterior ring fractures were all closed reduction and internally fixed with sacroiliac screws.

Results All 11 cases obtained follow-up from 13 to 20 months. Among them,2 patients had recurrence of postoperative infection,1 case was re-dissected and replaced with antibiotic bone cement-coated internal fixation,and 1 case had a milder infection without accumulation of the medullary cavity,and the infection was controlled by retaining the plate and replacing the antibiotic bone cement only after dissecting. Two cases developed incisional oozing,which healed after removal of the internal fixation three months postoperatively. All patients did not show pelvic fracture redisplacement or reinfection during the follow-up period. All 11 cases eventually healed bony. At the final follow-up,according to the Matta score,the fracture reduction was excellent in 6 cases,good in 4,and possible in 1. According to the Majeed functional score,it was excellent in 6,good in 3,and possible in 2.

Conclusion Antibiotic bone cement covered reconstruction plate is effective in the treatment of infected anterior pelvic ring fracture,with high intraoperative safety and low recurrence rate of infection,which is conducive to the early postoperative rehabilitation and significantly shortens the course of the disease.
KEY WORDS  Pelvic fracture  Internal fixation  Infection  Antibiotic bone cement
 
引用本文,请按以下格式著录参考文献:
中文格式:厉孟,王克竞,高振洋,谢云飞,郭涛.抗生素骨水泥被覆重建钢板治疗感染性骨盆前环骨折[J].中国骨伤,2024,37(5):451~457
英文格式:LI Meng,WANG Ke-jing,GAO Zhen-yang,XIE Yun-fei,GUO Tao.Antibiotic bone cement covered reconstruction plate for infected anterior pelvic ring fractures[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(5):451~457
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