Objective To introduce the application of induced membrane technique in surgical treatment of phalangeal osteo-myelitis of the hand or foot.Methods Five patients treated for phalangeal osteomyelitis of hand or foot from March 2021 to Ju-ly 2022 were retrospectively analyzed.The first surgical stage included debridement of infected tissues,insertion of an antibiotic cement spacer into the bone defect,closure of the wound,and administration of antibiotics intravenously for one week.The sec-ond surgical stage was performed after infection was controlled.It included removal of the cement spacer,preservation of the membrane,insertion and fixation of autologous bone grafts after repeat debridement of the bone edges,closure of the membrane containing graft without tension.Results All five patients were followed up after surgery,the follow-up periods were 10,14,16,17 and 32 months respectively.All bone infections were controlled after the first surgical stage,and there was no recurrence during follow-up.The patient with proximal interphalangeal joint osteomyelitis and the patient with middle phalanx osteomyeli-tis of second toe refused the second stage operation after their infections had been controlled.For the patient with distal phalan-geal osteomyelitis and the distal interphalangeal(DIP)joint involved,and the patient with DIP joint osteomyelitis,arthrodesis with autologous bone grafts at DIP joint was performed 6 and 8 weeks after the first surgical stage respectively.The patient with distal phalangeal osteomyelitis accepted distal stump bone graft 6 weeks after the first surgical stage.Nail plate and matrix units were preserved in all 3 patients.Due to the intolerance of K-wire's impact on daily life,two patients who underwent DIP ar-throdesis had their K-wires removed 6 and 9 weeks after the second surgical stage respectively,then they continued with exter-nal fixation brace treatment for another 2-3 months until bone healing was achieved.One patient was dissatisfied with nail shape,while all the other 4 patients were very satisfied with the figure and function of the phalanges.Conclusion Induced membrane technique is a feasible method in surgical treatment of phalangeal osteomyelitis of hand or foot.It creates conditions for repairing bone defects,maximally recovers finger or toe length,and achieves satisfactory appearance and function.
Phalange of handPhalange of footOsteomyelitisInduced membrane techniqueBone defectBone grafting
万方数据
维普
