带血管胸大肌蒂锁骨膜联合锁定钛板固定BMP植入治疗锁骨术后骨不愈合及骨缺损  

Combined application of vascularized pedicled pectoralis major clavicular periosteal flap and locking plate fixation plus bone morphogenetic protein implantation in the treatment of clavicular de- fect and nonunion after operation

作　　者：孙强[1] 郑加法[1] 

机构地区：[1]大连大学附属中山医院骨科,116001

出　　处：《中华创伤杂志》2009年第9期826-828,共3页Chinese Journal of Trauma

摘　　要：目的探讨锁骨骨折术后骨缺损、骨折不愈合的临床特点，评价锁定钛板固定骨形态发生蛋白（bone morphogenetic protein，BMP）植入联合带血管胸大肌蒂锁骨膜转位的治疗效果。方法2004年1月-2008年4月，锁骨骨折不愈合12例，平均年龄42．8岁，均行内固定物取出，清除骨折端纤维瘢痕及硬化骨，锁定钛板固定BMP植入，带血管胸大肌蒂锁骨膜转位覆盖，术后进行功能康复锻炼。结果12例患者术后均获得随访，时间8～24个月，平均1．2年，应用Constant—Murley肩关节评分系统进行评价，所有患者均在4～7个月达到临床愈合，部分患者已将内固定物取出。结论锁定钛板固定BMP植入联合带血管胸大肌蒂锁骨膜转位治疗锁骨骨缺损、骨不连，可取得良好的临床效果。Objective To investigate the clinical characteristics of clavicular defect and nonunion ＇after operation and evaluate the clinical effects of vascularized pedicled pectoralis major clavicular periosteal flap and locking plate fixation plus bone morphogenetic protein （BMP） implantation. Methods From January 2004 to April 2008, 12 patients （ mean age, 42.8 years old） with clavicular defect and nonunion were treated in Zhongshan Hospital. The internal fixators were removed, and then fibrous scars and sclerotic bones were cleared. The clavicular detects were fixed with locking plate, with implantation of the BMP. The wound was covered with vascularized pedicled pectoralis major clavicular periosteal flap. Postoperative functional rehabilitation exercises were performed, Results All patients were followed up for 8-24 months （mean 1.2 years）. The clinical results were evaluated by Constant-Murley scoring system. The clavicular defects were healed in all patients within 4-7 months, and the internal fixators were successfully removed from some of the patients. Conclusions Vascularized pedieled pectoralis major clavicular periosteal flap combined with locking plate fxation plus BMP implantation is effective in the treatment of clavicular defect and nonunion.

关 键 词：锁骨 骨折固定术 内 骨形态发生蛋白质类 带血管蒂骨膜瓣 

分 类 号：R687.3[医药卫生—骨科学]