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福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
福島医学会 = The Fukushima Society of Medical Science >
Fukushima Journal of Medical Science >
Vol.61 (2015) >
このアイテムの引用には次の識別子を使用してください:
http://ir.fmu.ac.jp/dspace/handle/123456789/492
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| タイトル: | Surgical treatment for infected long bone defects after limb-threatening trauma: application of locked plate and autogenous cancellous bone graft |
| 著者: | Kawakami, Ryoichi
Konno, Shin-Ichi
Ejiri, Soichi
Hatashita, Satoshi |
| 学内所属: | 整形外科学講座 |
| 誌名/書名: | Fukushima Journal of Medical Science |
| 巻: | 61 |
| 号: | 2 |
| 開始ページ: | 141 |
| 終了ページ: | 148 |
| 発行日: | 2015年 |
| 抄録: | Background: Treatment strategies for bone defects include free bone grafting, distraction osteogenesis, and vascularized bone grafting. Because bone defect morphology is often irregular, selecting treatment strategies may be difficult. With the Masquelet technique, a fracture site is bridged and fixed with a locking plate after treating deep infection with antibiotic-containing cement, and a free cancellous bone-graft is concomitantly placed into the defects. This procedure avoids excessive bone resection. Methods: We studied 6 patients who underwent surgical treatment for deep infection occurring after extremity trauma (2004 through 2009). Ages at surgery ranged from 29 to 59 years (largest age group: 30 s). Mean follow-up was 50.7 months (minimum/maximum: 36/72 months). One patient had complete amputation of the upper extremity, 3 open forearm fractures, 1 closed supracondylar femur fracture, and 1 open tibia fracture. In all patients, bone defects were filled with antibiotic-containing cement beads after infected site debridement. If bacterial culture of infected sites during curettage was positive, surgery was repeated to refill bone defects with antibiotic-containing cement beads. After confirmation of negative bacterial culture, osteosynthesis was performed, in which bone defects were bridged and fixed with locking plates. Concomitantly, crushed cancellous bone grafts harvested from the autogenous ilium was placed in the bone defects. Results: Time from bone grafting and plate fixation to bone union was at least 3 and at most 6 months, 4 months on average. Infection relapsed in one patient with methicillin-resistant Staphylococcus aureus, necessitating vascularized fibular grafting which achieved bone union. No patients showed implant loosening or breakage or infection relapse after the last surgery during follow-up. Conclusion: The advantage of cancellous bone grafting include applicability to relatively large bone defects, simple surgical procedure, bone graft adjustability to bone defect morphology, rapid bone graft revascularization resulting in high resistance to infection, and excellent osteogenesis. |
| 出版者: | The Fukushima Society of Medical Science |
| 出版者（異表記）: | 福島医学会 |
| 本文の言語: | eng |
| このページのURI: | http://ir.fmu.ac.jp/dspace/handle/123456789/492 |
| 本文URL: | http://ir.fmu.ac.jp/dspace/bitstream/123456789/492/1/FksmJMedSci_61_p141.pdf |
| ISSN: | 0016-2590
2185-4610 |
| DOI: | 10.5387/fms.2015-17 |
| PubMed番号: | 26377029 |
| 関連ページ: | http://doi.org/10.5387/fms.2015-17 |
| 権利情報: | © 2015 The Fukushima Society of Medical Science |
| 出現コレクション: | Vol.61 (2015)
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