摘要目的 探讨锁定加压钢板(LCP)外置技术在胫骨感染性骨不连治疗中的应用效果.方法 2005年2月至2011年11月应用LCP外置技术治疗11例胫骨感染性骨不连患者；男7例,女4例；年龄20～55岁,平均35.6岁.感染性胫骨骨不连根据Jain-Sinha分类方法分类:A型7例,B型4例.骨不连部位:胫骨下1/3段8例,中段2例,上段1例.7例患者采取清创植骨LCP外固定一期手术治疗,另外4例经一期清创LCP外固定并行软组织重建、待感染控制后二期植骨.术后定期复查X线片,并根据Olerud-Molander评分评定踝关节功能.结果 所有患者术后获10～26个月(平均14.3个月)随访.9例植骨术后正常愈合,2例出现延迟愈合；术后15～36周(平均22.0周)拆除外置的LCP和螺钉.术后原手术切口无感染,无神经、血管及肌腱损伤并发症；3例出现不同程度钉道感染；1例因钉道感染出现螺钉松动,并于术后2个月提前拔出近端松动的螺钉1枚.根据Olerud-Molander评分评定踝关节功能:优8例,良3例.结论 LCP外置治疗胫骨感染性骨不连简单、方便、稳定性好、患者易耐受,是其有效的治疗方法之一.

abstractsObjective To report our experience of using the locking compression plate (LCP) as an external fixation in the treatment of infected nonunion of the tibia.Methods Between February 2005 and November 2011 a total of 11 patients with infected nonunion of the tibia were treated by external fixation with LCP instead of by the traditional external fixation.They were 7 males and 4 females.Their average age was 35.6 years (range,20 to 55 years).According to the Jain-Sinha classification,7 cases were Type A and 4 Type B.Nonunion sites:the distal 1/3 tibia (8 cases),the middle tibia (2 cases) and the proximal tibia (one case).Seven cases were treated with debridement,bone grafting and LCP external fixation at one stage; the other 4 cases were treated with debridement,LCP external fixation and repair of soft tissues at the primary stage and bone grafting until the infection was controlled at the secondary stage.Results The patients were followed up for 10 to 26 months (average,14.3 months).Smooth healing was achieved in 9 cases after bone grafting and 2 cases had delayed healing.The LCP external fixators were removed after a mean time of 22.0 weeks (15 to 36).No incision infection,neurovascular or muscular complications occurred in these cases.Superficial screw tract infection occurred in 3 patients but resolved after intensive care; in one patient one screw at the LCP external fixator loosened due to screw tract infection and removed 2 months postsurgery.By the Olerud-Molander evaluation system,8 cases scored from 90 to 100 points and 3 cases from 80 to 89 points.Conclusion LCP as an external fixation is an effective treatment for infected nonunion of the tibia,because this techniques is simple,convenient,stable and well tolerated by the patients.