Use of Universal Mini External Fixator in the Management of Postosteomyelitic Defects in Short Tubular Bones in the Paediatric Population: 使用通用迷你外固定支架(Universal Mini External Fixator, UMEX)在兒科病人中治理因骨髓炎造成在短管狀骨的缺陷

Background/PurposeThe purpose of this study was to evaluate the results of reconstruction of postosteomyelitic defects in short tubular bones in a paediatric population using a universal mini external fixator (UMEX).MethodsThis was a prospective case series based on 10 consecutive cases who were followed-up for an average period of 3.5 years. Ten patients (mean age: 10.2 years) with an average shortening of 4 cm of the corresponding digit were operated upon using soft tissue distraction by UMEX followed by interposition bone grafting from the iliac crest. The second metacarpal was involved in five patients, the first metacarpal in three patients, and the proximal phalanx of the right big toe was involved in two patients.ResultsAll of the patients achieved union at the graft host site at an average of 12 weeks and an average of 3.8 cm lengthening of the digit was achieved. All patients had improved digit length, and function and appearance of the hand and toe. Apart from a minor pin tract infection and stiffness, there were no major complications. Final average follow-up at 3.5 years did not show any recurrence of infection or loss of correction.ConclusionWe believe that UMEX is a versatile method of managing postosteomyelitic defects in short tubular bones, with fewer complications and a high union rate, even in situations in which bone fragments are small and difficult to handle with other methods.

中 文 摘 要目的本研究的目的是評估使用通用迷你外固定支架(universal mini external fixator, UMEX)來重建在兒童因骨髓炎造成在短管狀骨的缺陷。設計十個病人的前瞻性病例報告，平均隨訪期為3.5年。方法和材料10例患者（平均年齡10.2年），患有平均4厘米的指骨縮短，接受了利用UMEX配合從髂骨提取的中間骨移植。有5例涉及第二掌骨，3例涉及第一掌骨和2例涉及右腳大腳趾的近節指骨。結果所有植骨都成功愈合，平均時間為12週，平均指骨加長3.8厘米。所有患者的指骨長度，功能和外觀都改善。除了一例有針道感染和僵硬，沒有嚴重併發症。 在最終平均隨訪3.5年中，沒有任何感染復發或失去校正。結論我們認為UMEX是治理因骨髓炎造成在短管狀骨的缺陷的方法。即使在骨碎片都非常小，和其他方法失敗的情況下，UMEX仍能有併發症少，癒合率高的效果。