トヤマ タケヤス   TOYAMA TAKEYASU
  外山 雄康
   所属   関西医科大学  整形外科学講座
   職種   助教
論文種別 原著(症例報告除く)
言語種別 英語
査読の有無 その他(不明)
表題 Finger Rescue Using the Induced Membrane Technique for Osteomyelitis of the Hand
掲載誌名 正式名:The journal of hand surgery Asian-Pacific volume
略  称:J Hand Surg Asian Pac Vol
ISSNコード:24248355/24248363
掲載区分国外
巻・号・頁 26(2),pp.235-239
著者・共著者 Toyama T, Hamada Y, Horii E, Kinoshita R, Saito T.
担当区分 筆頭著者
発行年月 2021/06
概要 Background: The induced membrane technique is now commonly used for large
diaphyseal bone defects. Recently, several papers reported using the induced
membrane technique for hand surgery. We applied this technique with some
modifications to treat osteomyelitis of the phalanges. Methods: This study
included six men and one woman with a mean age of 56 years. The causes of
osteomyelitis included animal bite (n = 3), trauma (n = 3), and an indwelling
needle (n = 1). Two-staged surgeries were performed, including an initial stage
with radical debridement of the infected tissue and placement of a cement spacer
into the bone defect. Four weeks after the first stage, a bone graft was
performed. A bone block with cortex was harvested from the iliac crest or
radius, and costal cartilage was used for proximal interphalangeal (PIP) joint
arthroplasty in two cases. Grafted bones were fixed with a mini screw or an
external fixator. Results: In all cases, the infection subsided, and bone union
was obtained within two to three months. No absorption of the grafted bone was
observed. In the two cases with PIP joint defect, joint motion without pain was
preserved at 56° and 26°. Conclusions: A short interval between the two surgical
stages of the induced membrane technique could be advantageous for patients in
terms of time and financial burden and early rehabilitation of movement.
Cortico-cancellous bone grafts were able to maintain bone length and stability
with screw fixation. In the cases with PIP joint defects, instead of
arthrodesis, we performed PIP arthroplasty using costal cartilage, eventually
obtained some motion without pain. The induced membrane technique was useful and
technically feasible for treating osteomyelitis in the hand, and secondary joint
reconstruction was possible to obtain some motion.
DOI 10.1142/S2424835521500247
PMID 33928851