重组合异种骨植骨治疗四肢长骨骨不连的疗效观察  

Comparison between the efficacy of recombinant bone xenograft and auto-ilinm in the treatment of long bone fracture non-union

作　　者：王志刚[1] 刘建[1] 孟国林[1] 胡蕴玉[1] 袁志[1] 

机构地区：[1]第四军医大学西京医院全军骨科研究,西安710032

出　　处：《中华骨科杂志》2008年第3期202-206,共5页Chinese Journal of Orthopaedics

摘　　要：目的探讨重组合异种骨与自体髂骨两种不同植骨材料植骨治疗四肢长骨骨不连的临床疗效。方法对255例1992年以来四肢长骨骨不连进行回顾性分析，其中男182例，女73例：6-75岁，平均34．9岁。骨不连部位：肱骨骨不连51例（男36例，女15例），尺、桡骨骨不连57例（男36例，女21例），其中尺桡骨同时骨不连10例，股骨骨不连67例（男43例，女24例），胫骨骨不连80例（男67例，女13例）。所有患者均行切开复位，并内固定或外固定。植骨来源：自体髂骨植骨88例。重组合异种骨（recombinant bone xenograft，RBX）植骨69例，自体髂骨联合RBX植骨74例。其他材料或不植骨22例。结果255例患者中12例失访。243例随访10个月-12年，平均4年6个月。总愈合率95．1％，自体髂骨组愈合率95．5％，RBX植骨组愈合率97．1％，自体髂骨联合RBX植骨组愈合率93．2％。各组之间差异无统计学意义（P〉0．05）。结论RBX与自体髂骨植骨治疗四肢长骨干骨不连。其愈合率差异无统计学意义。RBX植骨治疗骨不连。安全、生物相容性好。对促进骨愈合疗效可靠。Objective To compare and discuss the therapy efficacies of recombinant bone xenograft （RBX） and auto-ilium in the treatment of long bone fracture non-union. Methods 255 patients suffered with long bone fracture non-union since 1992 was analyzed retrospectively, which included 182 males and 73 females, with the mean age of 34.9 years （ranged from 6 to 75 years）. 51 cases had humerus non-union, 36 males and 15 females. 57 cases had ulnar or radial non-union （36 males and 21 females）, in which 10 cases had double bone non-union. 67 cases had non-union at femur （43 males and 24 females）. 80 cases had tibia non-union （67 males and 13 females）. All patients were performed open reduction with internal or external fixation. Of these cases, 88 had auto-ilium implantation （group AU） and 69 had RBX implantation （group RBX）. 74 cases had combined auto-ilium and RBX implantation. The other 22 cases had other kinds of bone implantation or no bone implantation at all. Results 12 cases among 255 cases lost follow-up. The average follow-up time of these 243 cases was 4 years and 6 months, from 10 months to 12 years. The total rate of fracture reunion was 95.1%. The reunion rate of group AU was 95.5% and that of group RBX was 97.1%. The reunion rate of auto-ilium and RBX implantation together was 93.2%. The fracture reunion difference between each group had no significance statistically. Conclusion The reunion rate had no obvious difference between RBX and auto-ilium in the treatment of long bone fracture non-union. RBX is much safe in the treatment of fracture non-union. It has nice biological compatibility and is efficacy in promoting bone fracture healing.

关 键 词：骨折 不愈合 骨移植 骨折固定术 内 

分 类 号：R687.3[医药卫生—骨科学]