[感染性胫骨骨不连的诊断和治疗检查]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-02-01 Epub Date: 2023-10-09 DOI:10.1007/s00113-023-01371-4
Simon Hackl, Alexander Eijkenboom, Matthias Militz, Christian von Rüden
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引用次数: 0

摘要

背景:骨折愈合失败是骨折治疗的主要并发症之一,尤其是胫骨,因为其软组织覆盖范围有限,开放性损伤发生率高。尽管植入物的开发不断进步,现代手术技术也在不断改进,但感染性胫骨骨不连在其多变的临床表现方面起着决定性作用。目的:为胫骨感染性骨不连的手术治疗提供指导。材料和方法:提出了将感染确定为骨折愈合失败的原因并实现感染和骨愈合的策略。结果:大量最初被认为是无菌性的胫骨骨不连最终被证明是感染性骨不连。结论:感染性胫骨骨不连的治疗需要广泛的临床、放射学和实验室诊断,以及对骨情况的深刻生物力学和生物学理解。这是通过尽可能少的翻修干预实现快速骨愈合的唯一方法。
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[Diagnostic and therapeutic work-up of infected tibial nonunion].

Background: The failure of bone fracture healing is one of the major complications of fracture treatment, especially of the tibia due to its limited soft tissue coverage and high rate of open injuries. Although implant development is constantly progressing and modern surgical techniques are continuously improving, infected tibial nonunion plays a decisive role in terms of its variable clinical presentation.

Objective: This article provides guidelines for the successful surgical treatment of infected tibial nonunion.

Material and method: Strategies are presented to identify infection as a cause of failure of fracture healing and to achieve infection and bone healing.

Results: A significant amount of tibial nonunions primarily thought to be aseptic ultimately turn out to be infected nonunions.

Conclusion: The treatment of infected tibial nonunion requires extensive clinical, radiological and laboratory diagnostics as well as a profound biomechanical and biological understanding of the bone situation. This is the only way to achieve rapid osseous healing with as few revision interventions as possible.

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