纳米人工骨在SchaterzkerⅡ～Ⅲ型胫骨平台骨折解剖形态重建中的应用  

Supportive plate combined with nano-artificial bone in anatomic reconstruction of Schaterzker Ⅱ-Ⅲ tibial plateau fracture

作　　者：蒋国华[1] 周富根[1] 吴永发[2] 曹烈虎[2] 禹宝庆[2] 李明[2] 马玉海 王心玲[3] 苏佳灿[2] 

机构地区：[1]浙江省嘉善县第一人民医院外二科,嘉兴314100 [2]第二军医大学长海医院骨科,上海200433 [3]中国人民解放军总后勤部第一门诊部,北京100842

出　　处：《第二军医大学学报》2010年第6期646-649,共4页Academic Journal of Second Military Medical University

基　　金：上海市科委纳米专项基金(0852nm04300);上海市卫生局中医药专项基金(2009S018);上海市人事专项基金(2009003)~~

摘　　要：目的观察纳米人工骨结合支持钢板手术重建SchaterzkerⅡ～Ⅲ型胫骨平台骨折的疗效。方法对33例Schat-erzkerⅡ～Ⅲ型胫骨平台骨折患者采用纳米人工骨结合支持钢板手术重建。全部病例术前均行正侧位摄片、CT扫描及三维重建,以准确了解骨折塌陷和粉碎程度及骨折碎片的翻转方向。凡骨折塌陷>3mm,且伤前无关节退行性变者,均作为该手术方法的适应证。结果除1例Ⅲ型严重粉碎性骨折术后8个月发生高度丢失,平台复位效果不佳外,术后X线片显示其余所有骨折均达到解剖复位或接近解剖复位。经6个月至2.5年[平均(1.5±0.6)年]的X线片和功能随访,维持解剖复位者28例(占85.7%);按Merchant评分标准评定膝关节功能优良29例(87.9%)。结论纳米人工骨结合支撑钢板手术重建SchaterzkerⅡ～Ⅲ型胫骨平台骨折能有效避免复位后的再丢失,改善远期疗效;纳米人工骨作为骨移植替代材料,具有良好的临床应用前景。Objective To observe the therapeutic effect of supportive plate combined with nano-artificial bone in treatment of Schaterzker Ⅱ-Ⅲ tibial plateau fracture.Methods Thirty-three patients with Schaterzker Ⅱ-Ⅲ tibial plateau fracture were treated with supportive plate combined with nano-artificial bone （Shanghai Rebone Biomaterials Co.,Ltd）.All the patients received X-ray film,CT scan and 3D reconstruction to accurately detect the degree of fracture collapse and the direction of bone chips before operation.If the fracture collapse of tibial plateau was more than 3 mm and there was no degeneration of the joint,the patients could be treated with supportive plate combined with nano-artificial bone.Results The postoperation X-ray films showed that all patients achieved complete or nearly anatomic reduction,except that one patient with severe Schaterzker Ⅲ comminuted fracture had height loss 8 months after operation and the result of plateau repair was not satisfactory.The patients were followed up for 6 months to 2.5 years （a mean of [1.5±0.6] years） and 28 （85.7%） patients maintained in complete or nearly anatomic reduction.Twenty-nine （87.9%）patients obtained good to excellent knee fucntion according to the Merchan Knee Functional Score.Conclusion Supportive plate combined with nano-artificial bone is a safe and effective treatment for Schaterzker Ⅱ-Ⅲ tibial plateau fracture,and it can avoid reduction loss and improve the long term outcomes of patients.Nano-artificial bone as a bone graft material has a bright future in clinic.

关 键 词：胫骨骨折 纳米人工骨 支持钢板 

分 类 号：R683.423[医药卫生—骨科学]