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

1.	Rodriguez-Merchan EC, Forriol F. Nonunion:general principles and experimental data[J]. Clin Orthop, 2004(419):4-12.
2.	曲龍,秦泗河. 伊利扎洛夫技術中Bone Transport的中文命名商榷[J]. 中華骨科雜志, 2009, 29(3):274.
3.	胥少汀, 葛寶豐, 徐印坎. 實用骨科學[M]. 3版. 北京:人民軍醫出版社, 2005:1563.
4.	周建旭, 馬憲平, 王嶺, 等. 骨搬移法配合中藥治療骨髓炎術后骨缺損的臨床研究[J]. 中國醫藥導報, 2009, 6(30):62-65.
5.	曾炳芳, 康慶林. 四肢骨不連外科學[M]. 北京:人民軍醫出版社, 2010:311-320.
6.	曲龍,施京輝,劉黎亮,等. 骨搬移法治療骨感染、骨缺損及軟組織缺損[J].中華外科雜志, 2004, 42(23):1469.
7.	陳輝,王愛民,沈岳,等.外固定支架骨搬移術對嚴重感染下肢骨缺損的治療[J].重慶醫學, 2008, 37(17):1961-1963.
8.	許建中, 李起鴻, 周仲安, 等. 感染性骨不連骨缺損的骨外固定治療[J]. 中華創傷雜志, 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. 骨延長術治療下肢骨缺損與骨不連[J]. 國外醫學·骨科學分冊, 2004, 25(4):218-220.
11.	艾田, 張俊德, 程添棟, 等. 伊里扎諾夫技術修復兔脛骨骨缺損成骨機制的研究[J]. 臨床骨科雜志, 2012, 15(2):202-204.
12.	高質鋼. 延長速度對肢體延長術的影響[J]. 中國矯形外科雜志, 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, 于慶巍, 劉光耀, 等. 骨延長速度對成骨過程的影響[J]. 中國組織工程研究與臨床康復, 2010, 14(39):7268-7272.
15.	王春妹, 舒衡生, 邵珩, 等. 周圍神經在緩慢肢體延長中的形態學觀察[J]. 中國矯形外科雜志, 2010, 18(18):1554-1558.
16.	張華, 李貴山, 于新民, 等. Ilizarov治療脛骨慢性骨髓炎27 cm超長骨搬移1例報告[J]. 中國矯形外科雜志, 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, 師紅立. X線聯合超聲對肢體延長術的監測價值[J]. 中國臨床醫學影像雜志, 2011, 22(1):27-30.

1. Rodriguez-Merchan EC, Forriol F. Nonunion:general principles and experimental data[J]. Clin Orthop, 2004(419):4-12.
2. 曲龍,秦泗河. 伊利扎洛夫技術中Bone Transport的中文命名商榷[J]. 中華骨科雜志, 2009, 29(3):274.
3. 胥少汀, 葛寶豐, 徐印坎. 實用骨科學[M]. 3版. 北京:人民軍醫出版社, 2005:1563.
4. 周建旭, 馬憲平, 王嶺, 等. 骨搬移法配合中藥治療骨髓炎術后骨缺損的臨床研究[J]. 中國醫藥導報, 2009, 6(30):62-65.
5. 曾炳芳, 康慶林. 四肢骨不連外科學[M]. 北京:人民軍醫出版社, 2010:311-320.
6. 曲龍,施京輝,劉黎亮,等. 骨搬移法治療骨感染、骨缺損及軟組織缺損[J].中華外科雜志, 2004, 42(23):1469.
7. 陳輝,王愛民,沈岳,等.外固定支架骨搬移術對嚴重感染下肢骨缺損的治療[J].重慶醫學, 2008, 37(17):1961-1963.
8. 許建中, 李起鴻, 周仲安, 等. 感染性骨不連骨缺損的骨外固定治療[J]. 中華創傷雜志, 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. 骨延長術治療下肢骨缺損與骨不連[J]. 國外醫學·骨科學分冊, 2004, 25(4):218-220.
11. 艾田, 張俊德, 程添棟, 等. 伊里扎諾夫技術修復兔脛骨骨缺損成骨機制的研究[J]. 臨床骨科雜志, 2012, 15(2):202-204.
12. 高質鋼. 延長速度對肢體延長術的影響[J]. 中國矯形外科雜志, 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, 于慶巍, 劉光耀, 等. 骨延長速度對成骨過程的影響[J]. 中國組織工程研究與臨床康復, 2010, 14(39):7268-7272.
15. 王春妹, 舒衡生, 邵珩, 等. 周圍神經在緩慢肢體延長中的形態學觀察[J]. 中國矯形外科雜志, 2010, 18(18):1554-1558.
16. 張華, 李貴山, 于新民, 等. Ilizarov治療脛骨慢性骨髓炎27 cm超長骨搬移1例報告[J]. 中國矯形外科雜志, 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, 師紅立. X線聯合超聲對肢體延長術的監測價值[J]. 中國臨床醫學影像雜志, 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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