自体红骨髓移植结合髓内钉治疗股骨粉碎型骨折相关因素的研究进展  

Developments in Autologous Red Marrow Transplantation for Treatment of Comminuted Femur Fracture

作　　者：吴昊[1,2] 张铁[1,2] 刘广辉[1,2] 史俊霞[1,2] 

机构地区：[1]内蒙古医科大学第二附属医院创伤外科,内蒙古呼和浩特010030 [2]内蒙古医科大学第二附属医院手足显微外科,内蒙古呼和浩特010030

出　　处：《内蒙古医学杂志》2013年第5期558-562,620,共6页Inner Mongolia Medical Journal

基　　金：内蒙古科技攻关项目(20070501)

摘　　要：骨折后延迟愈合与骨不连是骨科临床常见的并发症,临床中的治疗难题。交锁髓内钉闭式复位内固定术是治疗股骨干骨折的主要方法,在手术创伤、固定稳定性、应力遮挡、骨折愈合等方面优于非手术治疗,外固定支架,钢板内固定等治疗手段。红骨髓中富含BMSC和生长因子,未分化的BMSC在骨形成蛋白(BMPs)和生长因子的调控作用下,增殖分化为软骨细胞和成骨细胞,最后形成骨组织而达到骨性愈合。通过对红骨髓BMSC及生长因子对于骨折愈合的研究,髓内钉治疗股骨粉碎性骨折解剖、生物力学、促进愈合机制的分析,探讨自体红骨髓移植结合髓内钉闭式复位内固定术治疗股骨粉碎性骨折的新思路、新方法。本文就股骨粉碎性骨折治疗、愈合相关调控因素作一综述,以期初步揭示众多因素在骨折愈合中的作用。Delayed union and nonunion are the common clinical complications,and become the therapic difficulty in orthopaedics.Closed reduction of by interlocking intramedullary nail technique is the main treatment approach for femur fracture,which exhibits naticeable superiorty over non-surgical treatment,external fixator and plate internal fixation in operation wound,stability of fixation,stress shielding and fracture healing.The red marrow contain abundant BMSC and growth factors.Under the regulatory effect of bone morphogenetic proteins（BMPs） and growth factors,the undifferentiated BMSC proliferate and differentiate into cartilage cell and osteoblast,and finally form osseous tissue,leading to the bone union.For developing new treatment methods for comminuted long bone fracture via closed reduction by interlocking intramedullary nail technique combined with red marrow transplantation,the effects of BMSC and growth factors have been investigated.Herein,the treatments of femur fracture and healing regulatory factors have been reviewed,it is hoped to explore the effects of these factors on bone healing.

关 键 词：髓内钉 股骨骨折 BMSC 生长因子 

分 类 号：R683.42[医药卫生—骨科学] R687.33[医药卫生—外科学]