可吸收人工骨在跟骨粉碎性骨折复位内固定的应用

发布时间：2018-05-29 07:52

本文选题：跟骨 + 骨折　；参考：《中国矫形外科杂志》2017年22期

【摘要】：[目的]探讨可吸收人工骨粉修复跟骨粉碎性骨折的临床效果及生物相容性。[方法]纳入27例跟骨粉碎性骨折患者,均实施外侧"L"形入路骨折复位,复位后予以Genex人工骨粉进行骨缺损修复联合锁定钢板置入内固定治疗。观察手术相关情况,对患者进行Maryland足部功能评分,并测量B?hler角、Gissane角。[结果]27例患者均顺利完成手术治疗,手术时间55~90 min,平均70 min。术后所有患者切口均一期愈合,未出现切口感染或者皮瓣坏死等并发症。3例患者出现轻度切口皮缘坏死,均经积极对症处理后痊愈。全部病例随访10~18个月,平均12个月。末次随访时患者均达到骨性愈合。人工骨粉在术后6个月左右发生降解,12年个月后全部被吸收。术后12个月对患者进行Maryland足部功能评分,经评分和比较可以发现,较之术前,患者疼痛和功能以及对线、总分均显著提高。术后12个月,较之术前,患者的B?hler角显著增大,Gissane角显著缩小,较治疗前均得到显著的改善(P0.05)。患者均未出现炎性或排异反应。[结论]利用可吸收人工骨粉对跟骨粉碎性骨折患者进行治疗可以获得理想的修复效果,促进骨折愈合,有效改善关节功能,并具有良好的生物相容性。
[Abstract]:Objective to investigate the clinical effect and biocompatibility of absorbable artificial bone powder in the repair of comminuted calcaneal fracture. [methods] Twenty-seven patients with comminuted calcaneal fracture were treated with lateral "L" approach and treated with Genex artificial bone powder. The patients were evaluated with Maryland foot function score and the B?hler angle and Gissane angle were measured. [results] all 27 patients completed the operation successfully, the operation time was 5590 min (mean 70 min). All the incisions healed at the first stage, and there were no complications such as incision infection or skin flap necrosis. 3 cases had mild incision skin edge necrosis, all of them were cured after active treatment. All patients were followed up for 10 ~ 18 months (mean 12 months). Bone healing was achieved at the last follow-up. Artificial bone powder degraded about 6 months after operation and was absorbed 12 years later. After 12 months of operation, the patients were evaluated with Maryland foot function score. Compared with the patients before operation, the pain and function of the patients and the total score of the alignment were significantly improved. At 12 months after operation, the B?hler angle of the patients increased significantly and the angle of Gissane decreased significantly, which was significantly improved than that before treatment (P 0.05). No inflammatory or rejection reaction was found in all patients. [conclusion] the treatment of calcaneal comminuted fracture with absorbable artificial bone powder can obtain ideal repair effect, promote fracture healing, improve joint function and have good biocompatibility.
【作者单位】：河北大学附属医院骨科;河北保定市第一医院骨科;
【分类号】：R687.3

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