臨床整形外科53巻5号

2018年05月発行

誌上シンポジウム 外傷後・術後骨髄炎の治療

Masquelet法を用いた感染性偽関節の治療

著者： 渡部欣忍¹ 佐々木源¹ 宮本亘¹ 河野博隆¹

所属機関： ¹帝京大学医学部整形外科学講座

ページ範囲：P.383 - P.389

　感染性偽関節の治療は，1)局所感染の鎮静化と，2)巨大骨欠損の再建の2つを達成する必要がある．Debridement，pre-reconstruction stabilization，chemotherapyの3つにより局所感染を鎮静化させる．Debridement後に残った巨大骨欠損の再建法として，骨セメント・スペーサー充填と，セメント周囲に形成されるinduced membrane内への二期的自家海綿骨移植術(Masquelet法)は，新しい治療法として注目を集めている．当院では，自家海綿骨と人工骨(β-TCP)を併用したMasquelet法で骨再建を行っている．初期10例の治療成績は良好で，最大骨欠損長60mm(中央値)に対して，6カ月(中央値)で全例骨癒合が獲得できた．

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