A Locking Plate as a Definitive External Fixator for Treating Post-Traumatic Tibial Osteomyelitis

Hsing-Chier Hsueh ； Chin-Hsien Wu ； Ching-Hou Ma ； I-Ming Chou ； Yuan-Kun Tu

《E-Da Medical Journal》 9卷3期 (2022/09) Pp. 14-24

https://doi.org/10.6966/EDMJ.202209_9(3).0002

摘要

Objective: Evaluation of locking plate as a definitive external fixator for post-traumatic tibia osteomyelitis treatment. Methods: Eighteen consecutive post-traumatic tibial osteomyelitis patients were treated by performing a staged procedure that included hardware removal, radical debridement, locked plate definitive external fixator, and bone and soft-tissue reconstruction. Results: The follow-up time ranged between 18-48 months (mean: 31 months). The time until union ranged between 20-72 weeks (mean: 38.2 weeks). All except one patient were successfully treated using our protocol. All bone assessments indicated excellent and good results. The functional results ranged from excellent (14 patients), good (3 patients), and poor (1 patient). One patient had recurrent drainage. Tibiotalocalcaneal fusion was performed on two patients with equinis foot. Parenteral antibiotics was given to one patient who had superficial infections, which resolved with treatment. Length discrepancy greater than 2.5 cm was noted in three patients, and 10° procurvatum was noted in one patient. There were no deep infections due to the external fixator; minor screw track infections were noted in 4 patients. Conclusions: The locking plate used as a definitive external fixator provided good access for wound management and facilitated the treatment of associated injuries. While the locking plate is not entirely rigid, it is clinically stable and provides the necessary element of flexibility for bone healing. Our patients experienced smooth clinical courses, and had satisfactory functional results and acceptable complication rates.

關鍵字

tibial osteomyelitis ； external fixator ； locking plate ； posttraumatic

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