Analysis Of Clinical Efficacy Of Ilizarov Technique In The Treatment Of Chronic Osteomyelitis

Objective:To evaluate the clinical effect of Ilizarov technique in the treatment of chronic osteomyelitis.Methods:Retrospective analysis was made on 20 patients with chronic osteomyelitis admitted to our department from May 2019 to September 2022,including 14 male patients and 6 female patients,aged between 26-59 years,with an average age of 46.3years.The injured sites were tibia in 10 cases,femur in 6 cases,and humerus in 4cases.Causes of injury: 12 cases of traffic injury,5 cases of fall injury,and 3 cases of heavy crush injury;Among them,there were 6 open fractures and 14 closed fractures.The results of bacterial culture of the secretion at the sinus tract showed that 2 patients were negative and 18 patients were positive,including 10 cases of Staphylococcus aureus,4 cases of copper green monolobacter,3 cases of Bobalile Essence and 1 case of Proteus vulgaris.General preoperative data such as patients age,initial cause of injury,site of osteomyelitis,C-reactive protein,white blood cell count,procalcitonin,and erythrocyte sedimentation rate were recorded,and all chronic osteomyelitis patients included in the study were treated by Ilizarov technique.Ilizarov technique the treatment protocol is divided into 2 stages: Stage 1 consists of complete removal of the infected lesion,filling of the defect site with antibiotic bone powder and immobilization of the affected limb using an Orthofix unilateral external fixator,and stage 2 bone handling surgery after pending infection control.C-reactive protein,white blood cell count procalcitonin,erythrocyte sedimentation rate fracture healing was recorded at the postoperative follow-up visit,the recovery status of the affected limb was judged by imaging and functional status of the limb after the removal of external fixation,SF-36 scale,SCL90 self rating scale were used to comprehensively evaluate the treatment effect of Ilizarov technique on chronic osteomyelitis by contrast with the preoperative physiological and psychological status of the patients after surgery.Results:There were 20 patients in this study and all of them were followed up,and at the last follow-up,the C-reactive protein,procalcitonin,erythrocyte sedimentation rate,and white blood cell count of the patients were significantly lower than those of the patients before the operation,with a significant difference of P < 0.05;At the last follow-up,all patients included in the study achieved bone healing.According to the Paley bone healing evaluation criteria,5 cases were excellent,12 cases were good,and 3 cases were average,with an excellent and good rate of 85%.In terms of complications: 4 cases of nonunion at the junction end,3 patients had joint stiffness after removal of external fixation,5 patients had nail path infection,7 patients had skin traction pain during bone handling,2 patients had external fixation frame loosening,and 4 patients had bone block bias during bone handling.The problems were solved after corresponding treatment.The results of the SCL90 symptom self rating scale between the preoperative and postoperative periods of the patients showed that the patients’ postoperative somatic factors,obsessive-compulsive factors,interpersonal factors,depression factors,anxiety factors,hostility factors,fear factors,paranoid factors,mental status factors,and additional factors all assessed the patients’ psychological status scores better than the preoperative values,with significant differences(P<0.05).The results of patients’ preoperative and postoperative SF-36 scales showed that the results of a series of postoperative assessments of patients’ physiological status scores such as physiological function,physical function,pain,general health status,energy,social function,and emotional function were better than those before surgery,with statistically significant differences(P<0.05)Conclusions:1.The application of the Ilizarov technique for the treatment of chronic osteomyelitis can achieve satisfactory results,especially in the control of infection,and the technique is a simple,safe and effective solution for the treatment of chronic osteomyelitis.2.Ilizarov technique can solve the problem of large bone defects formed by removing infected lesions through slow and regular pulling of bone segments,and can significantly improve the psychological and physical status of patients and improve their quality of life.