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改良Masquelet技术联合Ilizarov Mini-Fixator治疗掌指骨大段骨缺损的临床疗效 被引量:3
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作者 李发祥 方有生 +3 位作者 艾克拜尔·亚森 谭玉忠 崔留超 田林 《实用手外科杂志》 2023年第1期36-40,共5页
目的探讨改良Masquelet技术联合Ilizarov Mini-Fixator外固定治疗掌指骨大段骨缺损的可行性、临床应用及疗效分析。方法回顾性分析2019年11月-2021年10月符合手术适应证的掌指骨大段骨缺损17例患者的病历资料,均行改良Masquelet技术联合... 目的探讨改良Masquelet技术联合Ilizarov Mini-Fixator外固定治疗掌指骨大段骨缺损的可行性、临床应用及疗效分析。方法回顾性分析2019年11月-2021年10月符合手术适应证的掌指骨大段骨缺损17例患者的病历资料,均行改良Masquelet技术联合Ilizarov Mini-Fixator外固定治疗。⑴创伤性骨缺损:一期急诊行“地毯式”清创及相应修复手术,抗生素聚甲基丙烯酸甲酯(Polymethylmethacyrlate,PMMA)填充骨缺损,皮肤软组织缺损者同时给予骨水泥覆盖;二期:行带蒂皮瓣或植皮修复皮肤缺损创面,伤口愈合6~8周后去除骨水泥行自体骨移植联合Ilizarov Mini-Fixator外固定治疗;⑵感染性骨缺损:一期彻底清创、PMMA填充骨缺损,皮肤软组织缺损或皮肤软组织条件较差者给予彻底清创修复创面;二期方案同创伤性骨缺损。术后均给予预防或控制感染、观察患指(肢)及皮瓣血运等对症处理,均早期(2周)进行功能康复训练。结果17例术后随访5~29个月,移植骨均愈合,平均愈合时间11.9周(10.5~14.0周),术后均未出现伤口感染及皮瓣坏死等并发症。16例伤口均甲级愈合,1例延期愈合,移植骨愈合优良率为82.35%。根据随访结果,骨折愈合康复结束后手部功能评估:优5例,良8例,可4例,优良率为70.47%。均实现保指(肢)的目的,部分患者获得较好的手功能。结论应用改良Masquelet技术联合Ilizarov Mini-Fixator治疗掌指骨创伤性及感染性大段骨缺损的方法疗效可靠,具有操作简单、经济实用、损伤小,且移植骨愈合率高、愈合快、并发症及风险小等优点。可早期进行功能训练,有助于恢复手的外观及功能。 展开更多
关键词 改良 Masquelet技术 大段 掌指骨骨缺损 Ilizarov mini-fixator
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改良Masquelet技术联合Ilizarov Mini-Fixator治疗掌指骨大段骨缺损的临床疗效 被引量:1
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作者 李发祥 方有生 +3 位作者 艾克拜尔·亚森 谭玉忠 崔留超 田林 《实用手外科杂志》 2023年第2期164-168,共5页
(文接上期)3讨论手作为人类生产、生活的主要工具,是最常受伤的部位之一。随着工业化进程,目前临床各种严重手外伤较为常见,且常合并神经、血管、肌肉肌腱、皮肤软组织及骨缺损。其中骨缺损的重建是手外科与显微外科治疗、研究的热点及... (文接上期)3讨论手作为人类生产、生活的主要工具,是最常受伤的部位之一。随着工业化进程,目前临床各种严重手外伤较为常见,且常合并神经、血管、肌肉肌腱、皮肤软组织及骨缺损。其中骨缺损的重建是手外科与显微外科治疗、研究的热点及难点。骨缺损即骨骼结构完整性被破坏,分为容积性骨缺损和结构性骨缺损。 展开更多
关键词 改良 Masquelet技术 大段 掌指骨骨缺损 Ilizarov mini-fixator
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Impact of the Ilizarov apparatus on external fixation: Current modifications of the 75-year-old orthopedic tool
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作者 Ilia Sutyagin Tatiana A Malkova 《World Journal of Orthopedics》 2025年第11期44-55,共12页
The Ilizarov apparatus was designed by its author 75 years ago and addresses a wide range of orthopedic conditions.Its classical assemblies are still self-sufficient and versatile.However,certain clinical scenarios re... The Ilizarov apparatus was designed by its author 75 years ago and addresses a wide range of orthopedic conditions.Its classical assemblies are still self-sufficient and versatile.However,certain clinical scenarios require a more specialized approach,and some groups of patients may benefit from customized Ilizarov constructs.Engineering science has designed various external fixators for orthopedic purposes,and some of those have become the gold standard for specific clinical tasks.We aimed to determine the current state and novel modifications of specialized external fixators for specific clinical situations which are based on the principles of the Ilizarov method.They are half-pin-based fixators for temporal fracture fixation,ring or hybrid devices for gradual deformity correction,and compression-distraction devices tailored for definite limb segments.Gradual correction of deformities can be achieved with external hexapods incorporating universal reduction units.Alternatively,external fixators with special connection mechanisms are able to provide independent movement of the rings in six degrees of freedom.Deformity correction can be performed with combined or sequential use of external and internal fixators.Special devices were developed for moving the split fragment for revascularization of the tibia.The units of external frames on the foot were modified to consider its complex anatomy and the clinical needs ranging from correction of multi-plane deformities,joint arthrodesis to distraction arthroplasty.Mini-fixators are compact external fixators for small bones of the hand and foot.The varieties of external fixators based on the Ilizarov principles have been designed to fulfill an ultimate goal of improving treatment outcomes. 展开更多
关键词 Ilizarov apparatus External fixation Distraction osteogenesis Bone lengthening Bone deformity Hexapod frame mini-fixator
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