骨搬移联合载药硫酸钙在治疗胫骨慢性骨髓炎中的疗效观察OA

Objective To summarize the efficacy of bone transport combined with drug-loaded calcium sulfate in the treatment of chronic tibial osteomyelitis.Methods This study employed a retrospective analysis approach,incorporating the medical records of 80 patients with chronic tibial osteomyelitis who were successfully treated with bone transport combined with drug-loaded calcium sulfate between June 2018 and June 2024 in People's Hospital of Xinjiang Uyghur Autonomous Region.A comprehensive evaluation of the surgical outcomes was conducted through comparative analysis of preoperative and postoperative blood infection marker levels[including complete blood count,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and procalcitonin(PCT)],radiological assessment of bone healing status(including mineralization duration of the extended bone segment and bone healing time at the docking site),incidence of postoperative complications,pain assessment using the visual analogue scale(VAS),and limb function recovery.Additionally,corresponding treatment measures were implemented and summarized for common postoperative complications.Results All enrolled patients completed postoperative follow-up.Among them,76 patients achieved primary healing(cure rate:95％),and 4 patients experienced postoperative recurrence(recurrence rate:5％).The time for complete normalization of blood infection markers ranged from 2 to 5 months,with an average of(3.5±0.5)months.Radiological assessment of bone healing indicators revealed that the complete mineralization time of the extended bone segment was 5 to 11 months,with an average of(7.0±2.5)months.The incidence of postoperative complications included 3 cases of non-union at the docking site(3.7％),3 cases of equinus deformity(3.7％),and 2 cases of pin tract infection(2.5％);no amputations were observed.The VAS scores were 7 to 9 points preoperatively,with an average of(8.0±1.2)points,and 2 to 3 points postoperatively,with an average of(2.0±0.5)points.Limb function recovery(based on the Paley scoring criteria)was excellent in 70 cases(87.5％),good in 6 cases(7.5％),fair in 4 cases(5％),and poor in 0 cases(0％);the excellent and good rate was 95％.The results of this study indicated that the postoperative evaluation indicators were significantly better than the preoperative ones,with a statistically significant difference(P<0.05).Conclusion This study demonstrates that the treatment of chronic tibial osteomyelitis and post-debridement bone defects using bone transport combined with drug-loaded calcium sulfate not only exhibits remarkable clinical efficacy but also has a low postoperative recurrence rate.It provides an efficient and safe therapeutic option for such patients and warrants further promotion and application in clinical practice.