张湘生医生的科普号

图1，刘某,左股骨中上段粉碎性骨折图2，行髓内钉钢丝内固定术后4月图3， 术后20月因感染行钢丝取出，出现骨吸收致大段骨缺损图4， 术后28月因感染持续存在行髓内钉取出，外固定支架固定，骨缺损约8cm图5，行骨痂延长术后图6，骨痂延长术后数月，骨痂生良好图7，骨延长术后1年半，患者延长段与骨不连处骨生长良好图8，骨延长的段与骨不连处骨愈合图9，拆除外固定支架

图1：右肱骨骨髓炎后骨缺损、骨不连。图2：用外固定支架行骨延长术，近端固定加压。图3：治疗后数月，骨延长区生长良好。图4;拆除外固定支架，予以螺钉固定近端。图5：骨完全愈合后，拆除螺钉情况。

图1：右股骨骨髓炎后骨不连接、骨短缩。图2：行外固定支架骨延长术，骨不连断端行加压处理。图3:骨延长术后4个月复查X线片，骨延长区生长良好，骨不连断端骨折线模糊。图4：治疗后半年，骨延长到位，骨不连区愈合良好。图5：治疗后4年，复查X片情况。

张湘生教授发表在国际骨科权威杂志（JBJS-Br）论文摘要 Nonunion of the humerus with bone loss and shortening due to osteomyelitis is rare but difficult to treat. We describe our experience with a callus distraction technique using a monolateral external fixator for the treatment of this condition. Between October 1994 and January 2004, 11 patients were treated. There were seven males and four females, with a mean age of 14 years (10 to 17). The mean bone loss was 1.9 cm (1 to 2.7) and the mean length discrepancy in the upper limb was 5.6 cm (3.5 to 8.0). The mean follow-up was for 106 months (54 to 166). The mean external fixation index was 34.8 days/cm (29.8 to 40.5). The mean lengthening was 9.5 cm (5.5 to 13.4). There were seven excellent results, three good and one poor. There were nine excellent functional results and two good. The treatment of humeral nonunion with bone loss and shortening due to osteomyelitis by callus distraction is a safe and effective means of improving function and cosmesis. (Liu T, Zhang X, Li Z, Zeng W, Peng D, Sun C.Callus distraction for humeral nonunion with bone loss and limb shortening caused by chronic osteomyelitis. . J Bone Joint Surg Br. 2008 Jun;90(6):795-800.)

张湘生教授发表在国际骨科权威杂志（JBJS-Br）论文摘要 We report our experience of the use of callus distraction with a monolateral fixator for the treatment of acquired radial club-hand deformity after osteomyelitis. Between 1994 and 2004, 13 patients with a mean age of eight years (4 to 15) were treated by callus distraction with a monolateral fixator after a preliminary period of at least four weeks in a corrective short-arm cast. All patients achieved bony union and were satisfied with the functional and cosmetic outcome. There were no major complications, but three patients required cancellous bone grafting at the docking site for delayed union. Local treatment and oral antibiotics were required for pin-site infection in six patients. There were no deep infection or recurrence of osteomyelitis. ( Zhang X, Duan L, Li Z, Chen X.Callus distraction for the treatment of acquired radial club-hand deformity after osteomyelitis. J Bone Joint Surg Br. 2007 Nov;89(11):1515-8.)

张湘生医师发表在国际骨科权威杂志（JBJS-Br）论文摘要 We present a retrospective study of 27 patients treated by callus distraction using a unilateral external fixator of our own design for nonunion with bone loss and shortening of the femur caused by suppurative osteomyelitis. The unilateral external fixator was used either alone or in combination with an intramedullary nail. The mean age of the patients was 13.6 years (8 to 18). The fixator was used alone in 13 patients and with an intramedullary nail in 14. The bone results at a mean follow-up of 88 months (37 to 144) were excellent in 16 patients and good in 11. The functional results were excellent in 18 patients and good in nine. However, four patients still had draining sinuses at the latest follow-up. A residual deformity greater than 7° was present in seven femora, but this did not adversely affect function or require further treatment. ( Zhang X, Liu T, Li Z, Peng W.Reconstruction with callus distraction for nonunion with bone loss and leg shortening caused by suppurative osteomyelitis of the femur. J Bone Joint Surg Br. 2007;89(11):1509-14.)

治疗前 患儿，郑某，女，9岁 反复骨折伴双股骨上段畸形7年 曾在我院内分泌科住院保守治疗无效 双大腿明显短缩、增粗、弯曲畸形 X线示双侧股骨拐状畸形并骨不连 治疗后 治疗后180天 双侧股骨均骨性愈合。髋内翻畸形明显矫正。可拆除支架 拆除支架后如图 治疗后150天 术后5月截骨端大量骨痂生长 治疗后0天 2008年10月在我科行双侧股骨截骨矫形+镶嵌式外固定支架固定术。

治疗前患者，女，35岁，小儿麻痹后遗症，影响患儿的生活、生长和发育成熟，不仅造成小儿身体畸形还为小儿生活自理、学习以及进入社会造成了严重障碍，使患儿的身心各方面都受到了打击。治疗后治疗后180天延长后功能情况如图治疗后90天延长中治疗后0天行左胫骨延长，胫骨上段矫形，踝关节融合术。

治疗前患者，男，12岁，先天性胫骨假关节，非常影响日常生活，不便利。治疗后治疗后90天予以病灶清除，外固定支架加压治疗。治疗后0天予以病灶清除，外固定支架加压治疗。

治疗前患者，女性，19岁，先天性肱骨头缺如，肱骨短缩，肘关节反位。治疗后治疗后0天截骨矫形，外固定支架固定