髓内钉支撑并组织工程化骨填塞治疗股骨近端骨纤维异常增殖症  

Intramedullary nailing support combined with tissue-engineered bone filling for treating fibrous dysplasia of the proximal femur

作　　者：陈鹏[1] 吴学建[1] 朱旭[1] 肖鹏[1] 

机构地区：[1]郑州大学第一附属医院骨科,河南省郑州市450002

出　　处：《中国组织工程研究》2014年第4期589-594,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:组织工程化骨在治疗大范围骨缺损并取自体髂骨移植受限时优势明显,可以有效填塞刮除后病灶及其他原因骨质缺损。目的:观察髓内钉支撑并组织工程化骨填塞治疗股骨近端骨纤维异常增殖症的治疗手段的合理性及组织工程化骨的生物相容性。方法:纳入明确病理诊断为骨纤维异常增殖症患者7例。所有患者均行髓内钉支撑并组织工程化骨填塞治疗。结果与结论:全部7例患者完成8个月以上随访,均无排异反应及并发症发生。7例患者固定4-6周后均拆除支具,髋关节活动度良好。固定后第10-12周复查X射线,患者无病理性骨折、无内固定松脱、无颈干角缩小,采用Harris髋关节评分系统评价7例患者患侧髋关节功能均为优。固定后第16-18周复查X射线可见髓内钉支撑并植骨区域骨爬行替代良好,固定后第24-26周可见病变范围内新生骨生长。固定后1.0-1.5年患者转子间病变区域基本完成骨爬行,X射线检查未见原病变痕迹。结果证实,髓内钉支撑并组织工程化骨填塞治疗股骨近端骨纤维异常增殖症效果良好,内固定稳定,同时减少切除自体髂骨量,中期随访观察患者固定后组织工程化骨生物相容好,髋关节功能活动良好。BACKGROUND： Tissue-engineered bone in the treatment of large bone defects has obvious advantages especially when the autologous ilium transplantation is limited, which can effectively fill bone defects. OBJECTIVE： To investigate the rationality of intramedullary nailing support and tissue-engineered bone filling in the treatment of fibrous dysplasia of the proximal femur and the biocompatibility of the tissue-engineered bone. METHODS： Seven patients with fibrous dysplasia of the proximal femur were subjected to intramedullary nailing support and tissue-engineered bone filling. RESULTS AND CONCLUSION： All of the seven patients underwent more than 8 months of follow-up, no rejection reaction and other complications occurred. After 4-6 weeks of fixation, all the seven patients removed hip spica braces, with a good hip mobility. After 10-12 weeks, X-ray review showed no pathological fracture, internal fixation loosening and narrow neck stem angle. Using the Harris hip score evaluation of the hip function, the affected side of the seven patients was optimized. After 16-18 weeks, X-ray films reviewed good creeping substitution in the affected area treated with the intramedullary nailing support and bone graft. After 24-26 weeks, new bone appeared within the scope of lesions. After 1.0-1.5 years, bone creeping substitution was basically completed in the intertrochanteric region, and original lesions were invisible on X-ray films. These findings confirmed that intramedullary nailing support and tissue-engineered bone filling for treating fibrous dysplasia of the proximal femur has good effectiveness, exhibiting stable internal fixation and avoiding resection of autogenous iliac bone. Tissue-engineered bone has a good biocompatibility in the medium-term follow-up, with good hip function activities.

关 键 词：植入物 骨植入物 骨纤维异常增殖症 股骨近端 髓内钉 组织工程化骨 内固定 生物相容性 

分 类 号：R318[医药卫生—生物医学工程]