自体骨、异种骨及人工骨微创植入治疗骨不连、骨缺损11例  

Autograft,xenograft or artificial bone minimally invasive grafting for 11 cases of bone nonunion and defects

作　　者：信维伟[1] 李展春[1] 董英海[1] 臧危平[1] 董宇启[1] 程光齐[1] 

机构地区：[1]上海交通大学医学院附属仁济医院骨科,上海市200127

出　　处：《中国组织工程研究与临床康复》2009年第5期953-956,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：回顾性分析上海市交通大学医学院附属仁济医院骨科2004-01/2007-12收治的骨折术后骨折延迟愈合、骨不连、骨缺损进行微创植骨的患者11例,局部麻醉或连续硬膜外麻醉下,在电视透视引导下定位,做5～8mm的切口。通过植骨器撑开软组织,切割、钳夹、取出纤维瘢痕组织,并打通硬化封闭的髓腔,形成新鲜植骨床。通过套筒将自体骨、异种骨或人工骨植入。植骨后每2周复查X射线片,观察植骨块吸收、骨再生以及骨折的愈合情况。10例患者植骨后一般情况好,无发热,伤口无明显肿胀、渗出等炎症反应,均为一期愈合。骨折延迟愈合或骨不连均在植骨后2～4个月(平均2.9个月)达到临床愈合,恢复正常负重。1例胫骨中下1/3开放性骨折骨不连患者3周内出现炎症反应,植骨后8个月仍未愈合。提示微创植骨术操作简便,创伤小,愈合较快,疗效较好。Eleven fracture patients with either delayed union, nonunion or bone defect were treated with minimally invasive bone grafting in Department of Orthopedics, Renji Hospital of Medica（ School, Shanghai Jiao Tong University between January 2004 and December 2007. Under local or epidural anaesthesia, a 5-8 mm skin incision was localized with the help of fluoroscopic image amplifier. Autograft, xenograft or artificial bone was grafted in a new prepared bone grafting region after removal of fibrotic tissues and recanalization of sclerotic medullary canal using minimally invasive grafting instruments. Bone resorption, regeneration and healing were observed from X-rays every two weeks after bone grafting. Ten fractures treated with minimally invasive bone grafting reached one stage healing without fever, wound swelling or exudation. All delayed union and nonunion reached clinical healing with normal weight bearing after 2-4 months （mean 2.9 months）. Inflammatory reaction occurred in one case with open fracture at 1/3 of middle and inferior tibia three weeks after operation. The fracture still remained nonunion 8 months after bone grafting. Minimally invasive bone grafting was an easy operation with short time, little injury and fast healing, which leads to good clinical outcomes.

关 键 词：骨移植 微创植骨术 骨不连 骨缺损 组织移植 

分 类 号：R617[医药卫生—外科学]