异体皮质骨板在股骨髁部粉碎性骨折内固定术中的应用  

Application of cortical bone plate allografts in fixation of comminuted fractures of femoral condyles

作　　者：郭志民[1] 龚星星[1] 丘小春 上官天丞 黄连水[1] 张萌[1] 庄泽民[1] 黄立羡[1] 

机构地区：[1]解放军第175医院全军骨科中心(厦门大学附属东南医院),福建漳州363000

出　　处：《中国骨与关节损伤杂志》2016年第2期142-145,共4页Chinese Journal of Bone and Joint Injury

基　　金：南京军区医学科技创新课题(MS096)

摘　　要：目的 探讨异体皮质骨板股骨内侧辅助固定结合外侧解剖型钢板内固定治疗股骨髁部粉碎性骨折的临床疗效。方法 自2006-03—2013-06采用异体皮质骨板股骨内侧辅助固定结合外侧解剖型钢板内固定治疗股骨髁部粉碎性骨折及该部位术后骨不连、钢板断裂及感染病灶清除术后骨缺损33例。结果 本组33例均获平均32（12~69）个月随访。骨折均愈合,平均愈合时间7.6（3~18）个月。无感染、内固定物松动、再骨折、免疫排斥反应等并发症发生。影像学资料示术后6个月异体骨板边缘变圆钝,异体骨板与宿主骨之间存在部分间隙,术后12个月异体骨板边缘进一步变薄、变圆,异体骨板两端与股骨之间间隙消失,可见边缘与宿主骨愈合征象。按Merchan等疗效评定标准进行膝关节功能评定：优16例,良12例,可4例,差1例,优良率84.8%。结论 应用异体皮质骨板股骨内侧辅助固定结合外侧解剖型钢板内固定治疗股骨髁部粉碎性骨折,增加了股骨内侧的支撑力度,提高了固定的稳定性,术后可以早期膝关节功能锻炼,减少钢板的疲劳断裂。Objective To investigate the clinical effectiveness of supplementary medial cortical bone plate allografts in conjunction with lateral anatomical plate in the treatment of comminuted fractures of the femoral condyles. Methods Between March 2006 to June 2013, 33 patients were treated by supplementary medial cortical bone plate allografts combined with lateral anatomical plate fixation, who suffered from comminuted fractures of the femoral condyles or nonunion, implant failure and osseous defect following bone infection. Results All patients were followed up for 12-69 months （mean, 32 months）. X-ray films showed bone union was achieved within 3-18 months （7.6 months on average）. No related complications occurred, such as infection, fixation loosening, refracture or immunological rejection. According to Merehan et al criteria for knee joint function evaluation, the results were excellent in 16 cases, good in 12 cases, fair in 4 cases, and poor in 1 case at last follow-up, the excellent and good rate was 84.8%. Conclusion Supplementary medial cortical bone plate allografts in conjunction with lateral anatomical plate fixation is a good method to treat comminuted fractures of the femoral condyles. This method can remarkably improve stability on the medial side of the femur as well as provide rigid fixation.

关 键 词：异体皮质骨板 股骨髁粉碎性骨折 钢板断裂 骨不连 

分 类 号：R683.42[医药卫生—骨科学]