诱导膜在感染性骨缺损治疗中的作用观察

doi:10.13418/j.issn.1001-165x.2017.04.022

Abstract

Abstract:

Objective To investigate the effect of induced membrane in the treatment of infective bone defects. Methods From January 2008 to December 2015, 38 patients with infective bone defects were treated with vancomycin bone cement packing and staged bone grafting. They were divided into encapsulation group with induced membrane(group A, 24 cases) and no-encapsulation group(group B, 14 cases).Bone healing, recurrence of infection and intervention of resurgery were recorded, grade of bone healing and adjacent joint functional recovery were evaluated according to Paley method, respectively. Results All patients were followed up for 12 to 51 months, with an average of 19.6 months. In group A, all healed by first intention, the clinical healing time was 3.0～7.0 months, with an average of 5.2 months; in group B, 1 case had bone nonunion, and the clinical healing time was 3.0～15.0 months, with an average of 6.64 months. 1 case with recurrence of infection was noted in group A whereas 3 cases were noted in group B. 3 cases required intervention of resurgery in group B whereas no case was noted in group A. The clinical healing time and intervention rate of resurgery were statistically different (P<0.05); a trend of higher recurrence rate in group B than in group A was noted although there was no significant difference between the two groups (P>0.05). At the last follow-up, there was no significant difference between the two groups in the grade of bone defect healing and the functional recovery of the adjacent joint (P>0.05). Conclusion The integrity of the induced membrane is related to bone healing, and the induced membrane formed after packing of antibiotic bone cement has a protective effect on the recurrence of infection.

Key words: , Induced membrane technique； , Induced membrance； , Bone defect； , Osteomyelitis

YIN Qu-dong， GU San-jun， SUN Zheng-zhong， WU Yong-wei, RUI Yong-jun, HU Hui-dong . Observation of the effect of induced membrane in the treatment of infective bone defects[J]. Chinese Journal Of Clinical Anatomy, 2017, 35(4): 459-462.

References

[1] 雷鸣，王敏，张催. 万古霉素骨水泥对骨折内固定术后髓内感染的疗效观察[J]. 抗感染药学, 2014, 11(5):538-540.
[2] 陈肖健. 负压引流术联合万古霉素骨水泥植入治疗慢性骨髓炎的临床疗效分析[J]. 中国慢性病预防与控制, 2013, 21(2): 231-233.
[3] Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft[J]. Ann Chir Plast Esthet, 2000, 45(3):346-353.
[4] Morelli I, Drago L, George DA, et al. Masquelet technique: myth or reality? A systematic review and meta-analysis[J]. Injury, 2016, 47(Suppl 6):S68-S76.
[5] 殷渠东, 孙振中, 顾三军. 应用Masquelet技术修复骨缺损研究进展[J]. 中国修复重建外科杂志, 2013, 27(10):1273-1276.
[6] Wang X, Wang Z, Fu J, et al. Induced membrane technique for the treatment of chronic hematogenous tibia osteomyelitis[J]. BMC Musculoskelet Disord, 2017, 18(1):33.
[7] Paley D, Herzenberg JE, Paremain G, et al. Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening[J]. J Bone Joint Surg Am, 1997, 79(10):1464-1480.
[8] Luo F, Wang X, Wang S, et al. Induced membrane technique combined with two-stage internal fixation for the treatment of tibial osteomyelitis defects[J]. Injury, 2017, 48(7):1623-1627.
[9] 汪小华, 傅景曙, 沈杰, 等. 诱导膜技术治疗胫骨创伤后骨髓炎[J]. 中华创伤杂志, 2015, 31(4): 299-302.
[10] 殷渠东, 顾三军, 孙振中, 等. 钛网包裹打压植骨修复大段骨缺损初步报告[J]. 中国临床解剖学杂志, 2015, 33(1):101-104.
[11] 魏富达，汪小华，谢肇. PMMA骨水泥与磷酸钙骨水泥诱导成膜及其对成骨活性的差异[J].第三军医大学学报， 2015，37（10）：973-977.
[12] 陈红卫, 赵钢生, 鲍丰, 等. 一期病灶清除载药磷酸钙人工骨充填治疗慢性骨髓炎[J]. 临床骨科杂志, 2008, 11(6):512-514.
[13] Pannier S, Pejin Z, Dana C, et al. Induced membrane technique for the treatment of congenital pseudarthrosis of the tibia:preliminary results of five cases[J]. J Child Orthop, 2013,7(6):477-485.
[14] 殷渠东，顾三军，孙振中，等. Masquelet技术体外制作骨水泥填塞物治疗骨缺损的临床应用[J]. 中华创伤杂志，2016，32(4)：370-372.
[15] 李林, 林达生, 郝健明, 等. Masquelet技术治疗胫骨大段骨缺损的疗效分析[J].中华创伤骨科杂志, 2014, 16(1):88-90.
[16] Konda SR, Gage M, Fisher N, et al. Segmental bone defect treated with the induced membrane technique[J].J Orthop Trauma, 2017, 31(Suppl 3): S21-S22.
[17] Wong TM, Lau TW, Li X, et al. Masquelet technique for treatment of posttraumatic bone defects[J]. Scientific World Journal, 2014, 2014:710302.
[18] Christou C, Oliver RA, Yu Y, et al. The Masquelet technique for membrane induction and the healing of ovine critical sized segmental defects[J]. PLoS One, 2014, 9(12): e114122.
[19] 殷渠东，顾三军，芮永军，等.诱导膜技术治疗骨缺损的疗效分析[J].中华骨科杂志, 2016, 36(20): 1284-1293.
[20] 李宗原, 唐诗添, 王军, 等. Masquelet技术联合组织瓣移植修复骨软组织复合缺损[J]. 中国修复重建外科杂志, 2016, 30(8): 966-970.

Observation of the effect of induced membrane in the treatment of infective bone defects

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 0

[1]	Jiang Jianhong, Duan Renpeng, Li Xiaofeng. Application of three-dimensional visualization technology in the anatomical variations of hilar bile ducts in Chinese population [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 1-4.
[2]	Guo Hongzhi, Wang Yu, Zhang Jiaqi, Liang Haibin, Ma Ziwei, Feng Wei, Wu You, Si Ziyi. Evaluation of placental vascular structure in preeclampsia by vascular casting combined with CT three-dimensional model [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 5-10.
[3]	Li Jiawei, Zhang Jing, Li Canran, Lan Wenjie, Ji Qingyu, Guo Zhiyong, Zhang Yunfeng, Liu Qi, Chen Qingwei, Li Xiaohe. X-ray measurement of proximal femur anatomical parameters in Mongolian population [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 11-16.
[4]	. Digital measurement and clinical significance of occipitocervical Angle and posterior occipitocervical Angle in children and adolescents [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 17-20.
[5]	Li Wen, Yang Siyi, Huang Lei, Qing Jiwen, Jiang Songtao, Zhang Lei. Morphological characteristics and clinical significance of Lisfranc ligament based on MRI [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 21-25.
[6]	Li Fanfan, Xu Yang, Wang Xiaoxu. Therapeutic effect of shikonin on the treatment of granuloma lobular mastitis in model rats by regulating Nrf2/HO-1 signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 26-32.
[7]	Wang Xinghang, Ding Jiayuan, Li Fang, Bao Cuifen, Yan Lijing. Ginsenoside Rg1 reduces the inflammatory response of microglia after oxygen glucose deprivation/resupply by inhibiting the NLRP3 inflammasome pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 33-41.
[8]	Cheng Yingying, Wu Jianjun, Cai Haiyan , Jiao Xunwen, Ma Jiangbo, Ding Yinxiu. Activation and functional changes of astrocytes cultured in vitro under inflammatory stimulation [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 42-46.
[9]	Qi Zhi, Yang Li, Jia Qiuye, Chen Haolun, Duan Zhaoda, Wu Chunyun. Edaravone regulates Sirt3 expression in lipopolysaccharide-activated microglia via MAPKs signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 47-53.
[10]	Zhang Jingjing, Wang Hongxin. Protective effect of Baicalin on rats with pulmonary hypertension through PDGF/P38 MAPK signaling pathway [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 54-58.
[11]	Yue Qin, Chen Rongli, Xiong Jingxi, Wang Tingyi, Cai Zhiheng, Yi Qiushi, Zeng Xinyi. Effect of Bletilla striata polysaccharides on the choke-area of cross-boundary flap in rats [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 59-64.
[12]	Li Xiaoyu , Zhang Lei , Fu Lei , Li Dongbo , Wang Guoyou. Finite element study on the treatment of Sanders type II calcaneal fracture with three-step reduction method [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 65-70.
[13]	Wu Yanfei, Ma Jianxiong, Lu Bin, Wang Ying, Bai Haohao, Jin Hongzhen, Ma Xinlong. Study on the correlation between the reconstruction of grayscale values using CT post-processing technology and the compressive strength of the endplate [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 71-76.
[14]	Zhuang Wanqiang, Tang Yi, Luo Yonggang, Zhang Hui. An early and mid-term retrospective study of the effects of arthroscopy combined with high tibial osteotomy on patellar position and patellofemoral joint function [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 77-82.
[15]	Luo Ying, Dou Weiyu, Wu Xiaohang, Chen Jingkun, Peng Changgui, Pan Jianying . Risk factors of postoperative complications of calcaneal fractures treated with hippocampal plate internal fixation through minimally invasive method [J]. Chinese Journal of Clinical Anatomy, 2024, 42(1): 83-88.