球囊扩张可注射硫酸钙骨水泥填充治疗胫骨平台塌陷骨折的可行性  

Feasibility of balloon dilation with injectable calcium sulfate cement for tibial plateau fractures

作　　者：陈金民 陈穗生 丁晶 夏暴权 罗晓嘉 卢成海 杨镇铿 Chen Jin-min;Chen Sui-sheng;Ding Jing;Xia Bao-quan;Luo Xiao-jia;Lu Cheng-hai;Yang Zhen-keng(Second Division of Surgery,Guangzhou Baiyun District First People＇s Hospital,Guangzhou 510410,Guangdong Province,China;Department of Orthopedics,General Hospital of Kunming Military Region,Kunming 650032,Yunnan Province,China)

机构地区：[1]广州市白云区第一人民医院外二科,广东省广州市510410 [2]解放军昆明总医院骨科,云南省昆明市650032

出　　处：《中国组织工程研究》2018年第18期2795-2799,共5页Chinese Journal of Tissue Engineering Research

基　　金：广州市白云区科技计划项目(2016-kz-020);项目名称:球囊扩张复位可注射硫酸钙填充治疗胫骨平台塌陷骨折的可行性及力学研究;承担单位:广州市白云区第一人民医院~~

摘　　要：背景:球囊扩张技术对脊柱后凸畸形具有重要的矫正作用,将其应用于扩张椎体后凸成形中可形成空腔,在低压力下灌注骨水泥,为脊柱的稳定性奠定基础。目的:探讨球囊扩张可注射硫酸钙骨水泥填充治疗胫骨平台塌陷骨折的可行性,分析其临床应用效果。方法:取新鲜成年人胫骨上段标本24个,制作胫骨平台SchatzkerⅢ型塌陷骨折模型后,随机分为3组:标准组进行开窗撬拨复位自体骨移植松质骨拉力螺钉内固定治疗,单纯骨水泥组进行球囊扩张复位硫酸钙骨水泥填充治疗,骨水泥螺钉组进行松质骨拉力螺钉内固定联合球囊扩张复位硫酸钙骨水泥填充治疗,观察复位固定的一般情况,测量复位效果。结果与结论:(1)模型固定效果:3组模型均复位良好,标准组、单纯骨水泥组、骨水泥螺钉组复位后的平均位移分别为(-0.22±0.62),(-0.23±0.67),(-0.20±0.69)mm,3组位移比较比较差异无显著性意义(P>0.05);(2)临床应用效果:选择1例左侧胫骨平台SchatzkerⅢ型骨折患者,进行松质骨拉力螺钉内固定联合球囊扩张复位硫酸钙骨水泥填充治疗,术后3 d复查X射线可见硫酸钙骨水泥;术后30 d复查,关节活动范围较好,硫酸钙部分吸收;术后60 d复查,关节无伸直障碍,X射线显示骨折愈合,硫酸钙吸收;(3)结果表明:经皮球囊扩张可注射硫酸钙骨水泥填充治疗胫骨平台塌陷骨折具有可行性,有临床应用价值。BACKGROUND： The balloon dilatation technique plays an important role in the correction of kyphosis. A balloon catheter can enlarge the spinal cavity in kyphoplasty followed by injection of bone cement under low pressure to lay a foundation for the stability of the spine. OBJECTIVE： To explore the feasibility of balloon dilation with injectable calcium sulfate cement for tibial plateau fractures and to analyze its clinical effect. METHODS： Twenty-four upper tibia specimens of the adults were taken to make the Schatzker Ⅲ collapsed fracture model of the tibial plateau. Then, these specimens were randomized into three groups： the standard group was subjected to poking reduction with autologus bone grafting and screw internal fixation, the bone cement group was inflated with balloon dilatation followed by calcium sulfate cement injection, and the combined group was treated with fixation with cancellous bone screws and balloon dilatation followed by injection of calcium sulfate cement. The general situation of reduction and fixation was observed and the reduction effect was measured. RESULTS AND CONCLUSION： （1） Fixation effect in the model： All three models were well reset, and the average displacement of the standard group, the simple bone cement group and the bone cement screw group was （-0.22±0.62）, （-0.23±0.67）, and （-0.20±0.69） mm, respectively. There was no significant difference in the displacement between the three groups （P 〉 0.05）. （2） Clinical application： One case of Schatzker type Ⅱ fracture of the left tibial plateau was treated with cancellous bone screw fixation and balloon dilatation followed by injection of calcium sulfate cement. X-ray results showed calcium sulfate cement was visible at 3 postoperative days. At 30 postoperative days, the patient presented with good joint range of motion, and the calcium sulfate was partially absorbed on the X-ray film. At 60 postoperative days, the patient appeared to have no joint extension disorder, and fracture heal

关 键 词：硫酸钙骨水泥 球囊扩张 胫骨平台骨折 关节镜 生物力学 生物材料 

分 类 号：R318[医药卫生—生物医学工程]