两种不同材料外固定器修复胫骨骨折:新型PEEK复合材料外固定器更有优势  

PEEK external fixator is better for repair of tibial fractures

作　　者：张觅[1] 刘洋[1] 谭俊峰[1] 梅红军[1] 张红旗[2] 

机构地区：[1]武汉市第五医院(江汉大学第二附属医院)骨科,湖北省武汉市430050 [2]武汉理工大学力学研究中心,湖北省武汉市430060

出　　处：《中国组织工程研究》2015年第38期6145-6149,共5页Chinese Journal of Tissue Engineering Research

基　　金：亚洲创伤骨科学会(AADO)研究基金资助项目(AADO-RF2011-002-2Y)~~

摘　　要：背景:胫骨骨折传统外固定存在明显应力遮挡,骨折延迟愈合不愈合,聚醚醚酮树脂(polyetheretherketone,PEEK)材料弹性模量接近骨质,将有可能解决这一临床难题。目的:比较胫骨骨折采用新型PEEK复合材料外固定器和传统材料外固定器外固定治疗效果。方法:回顾分析胫骨骨折86例,男64例,女22例;年龄24-78岁,平均56岁;闭合性骨折30例,开放性骨折56例;平诊手术32例,急诊手术54例。所有患者根据外固定方法不同分为2组,分别采用新型PEEK复合材料外固定器和传统材料外固定器治疗。固定后定期复查X射线片,末次随访时根据Johner-Wruhs胫骨干骨折疗效评价标准评定功能恢复情况。结果与结论:所有患者固定后均获5-20个月随访。PEEK组平均8.7周拆除外固定器,4.2个月骨折愈合;传统材料外固定器平均10.6周拆除外固定器,6.1个月骨折愈合。末次随访时根据Johner-Wruhs胫骨干骨折疗效评价标准评定功能恢复情况:PEEK组优26例,良13例,差4例;传统材料外固定器优19例,良13例,差11例。结果表明,应用PEEK复合材料外固定器治疗不同类型胫骨骨折较传统材料外固定器治疗具有可保持骨折稳定、促进骨折愈合、利于患肢功能恢复的优势。BACKGROUND： Traditional external fixation of tibial fractures exhibits obvious stress shielding that delays fracture healing. Polyetheretherketone（PEEK） material has a similar elastic modulus to the bone, and it will be possible to address this clinical problem. OBJECTIVE： To compare the outcome of PEEK external fixator versus traditionally external fixator in the treatment of tibial fractures. METHODS： Clinical data of 86 patients with tibial fractures, including 64 males and 22 females, aged 24-78 years（mean age of 56 years）, were retrospectively reviewed. There were 30 cases of closed fractures and 56 cases of open fractures; 32 cases received flat-patient surgery and 54 cases underwent emergency surgery. All the patients were divided into two groups according to different fixation methods： PEEK group and traditional external fixator group. After operation, patients were checked regularly and at the last follow-up, functionalrecovery was evaluated according to Johner-Wruhs criteria. RESULTS AND CONCLUSION： All the patients were followed up for 5-20 months. The mean fixator removal time of the PEEK group was 8.7 weeks and the mean duration of fracture healing was 4.2 months. The mean fixator removal time of the traditional external fixator group was 10.6 weeks and the mean duration of fracture healing was 6.1 months. At the last follow-up, in the PEEK group, 26 cases were assessed as excellent, 13 as good, 4 as poor; in the traditional external fixator group, 19 cases were assessed as excellent, 13 as good, 11 as poor. These findings indicate that PEEK external fixator for different types of tibial fractures can maintain the fracture stability, promote fracture healing and contribute to the functional recovery of the affected limbs.

关 键 词：胫骨 骨折 骨折愈合 生物材料 骨生物材料 聚醚醚酮树脂(PEEK) 胫骨骨折 外固定器 回顾性分析 

分 类 号：R318[医药卫生—生物医学工程]