可吸收人工骨在跟骨粉碎性骨折复位内固定的应用  

Application of absorbable artificial bone in reduction and internal fixation of comminuted calcaneus fracture

作　　者：侯煜[1] 孙博[1] 梁志兴[1] 胡海静 宋静[2] 孙少松 焦建宝[1] 王林杰[1] 

机构地区：[1]河北大学附属医院骨科,河北保定071000 [2]河北保定市第一医院骨科,071000

出　　处：《中国矫形外科杂志》2017年第22期2046-2049,共4页Orthopedic Journal of China

摘　　要：[目的]探讨可吸收人工骨粉修复跟骨粉碎性骨折的临床效果及生物相容性。[方法]纳入27例跟骨粉碎性骨折患者,均实施外侧"L"形入路骨折复位,复位后予以Genex人工骨粉进行骨缺损修复联合锁定钢板置入内固定治疗。观察手术相关情况,对患者进行Maryland足部功能评分,并测量B?hler角、Gissane角。[结果]27例患者均顺利完成手术治疗,手术时间55~90 min,平均70 min。术后所有患者切口均一期愈合,未出现切口感染或者皮瓣坏死等并发症。3例患者出现轻度切口皮缘坏死,均经积极对症处理后痊愈。全部病例随访10~18个月,平均12个月。末次随访时患者均达到骨性愈合。人工骨粉在术后6个月左右发生降解,12年个月后全部被吸收。术后12个月对患者进行Maryland足部功能评分,经评分和比较可以发现,较之术前,患者疼痛和功能以及对线、总分均显著提高。术后12个月,较之术前,患者的B?hler角显著增大,Gissane角显著缩小,较治疗前均得到显著的改善(P<0.05)。患者均未出现炎性或排异反应。[结论]利用可吸收人工骨粉对跟骨粉碎性骨折患者进行治疗可以获得理想的修复效果,促进骨折愈合,有效改善关节功能,并具有良好的生物相容性。： [Objective] To investigate clinical outcome and compatibility of bioahsorbable arlifieial bone for repair commi- Muted fracture of calcaneus. [Methods] Twenty-seven patients with eomminuted ealcaneal fracture were surgically treated hy open reduction, GeneX artificial hone implantation to fill the bone defects combined with locking plate internal fixation through the ＂L＂ lateral shaped approach. Maryland foot score, Bohler angle and Gissane angle measured on the X-ray films were used for evaluation of the consequence. [Results] All the patients were successfully completed surgery, with operation time of 70 rain on average ranged from 55 to 90min. The incision healed in all patients, without complications such as wound infection or flap necrosis. However, 3 patients had mild skin necrosis on incision edges, which healed following a proper active treatment. All the patients were fnllowed up for an average of 12 months ranged from 10 to 18 months. At the latest follnw-up, all of them achieved bony healing. The implanted artificial hone was degraded at 6 months, and absorbed completely at12 months atier operation. Maryland font scores, including pain, function, alignment and total score, significantly increased at 12 months after operation compared with those before operation （P〈0.05）. In addition, Bohler angle significantly increased whereas Gissane angle signifi- cantly reduced at the latest follow up, compared with those before surgery （P〈0.05）. No inflammatnry reaction or rejection hap- pened in any patient. [Conclusion] Application of this absorbable artificial hone for eomminuted caleaneus fracture achieves satisfaetnry results in maintaining reduction and improving fracture healing with a good biocompatibility.

关 键 词：跟骨 骨折 人工骨 修复 生物相容性 

分 类 号：R687.3[医药卫生—骨科学]