郝建强 韩涛 李闯兵 高秋明

    【摘要】 四肢长骨慢性骨髓炎是一种具有挑战性的骨科难题，目前多采用手术清除局部病灶联合抗菌药物等多种手段治疗。但是，目前彻底清创手术治疗现无统一的指南或专家共识，清创范围的界定显得尤为重要。术前评估应从症状、体征、实验室检查及影像学表现等多个方面确定手术指征及清创范围，术中视组织情况分辨并切除病变组织，同时辅以皮瓣、骨水泥、生物材料等多种外科技术填充无效腔。本文就四肢长骨慢性骨髓炎的疾病特点及治疗的研究进展进行了综述。

    【关键词】 慢性骨髓炎 清创 四肢长骨

    [Abstract] Chronic osteomyelitis of Long Bones of extremities is a challenging orthopedic problem， at present， surgical removal of local lesions combined with antibiotics and other methods are used to treat it. However， at present， there is no unified guideline or expert consensus for the treatment of radical debridement， so it is particularly important to define the scope of debridement. Preoperative evaluation should determine the surgical indication and the scope of debridement from multiple aspects such as symptoms， signs， laboratory examination and imaging findings. During the operation， the pathological tissues should be identified and removed according to the condition of the tissues， meanwhile， various surgical techniques such as flaps， bone cement and biological materials should be used to fill the dead space. This article reviews the disease characteristics and treatment progress of chronic osteomyelitis of extremities. ......