注射型植骨修复锁骨中段骨折内固定治疗后的骨不连  

Injectable bone graft for the repair of nonunion of midshaft clavicular fracture after internal fixation

作　　者：谌少波 双峰[1] 胡炜 李浩[1] 邵银初 Chen Shaobo;Shuang Feng;Hu Wei;Li Hao;Shao Yinchu(No.908 Hospital of Joint Logistic Support Force of Chinese PLA,Nanchang 330002,Jiangxi Province,China)

机构地区：[1]中国人民解放军联勤保障部队第908医院,江西省南昌市330002

出　　处：《中国组织工程研究》2020年第34期5473-5477,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81660377),项目负责人:双峰;江西省自然科学基金资助项目(20171BAB205032),项目负责人:双峰;江西省卫生计生委科技计划项目(20163018),项目负责人:双峰。

摘　　要：背景:锁骨骨折骨不连的治疗通常需要植入骨材料促进骨愈合,注射型植骨材料已被成功用于治疗四肢骨折及腰椎融合,但其用于骨不连治疗的研究较少。目的:探讨注射型植骨材料治疗锁骨中段骨折内固定后骨不连的临床疗效。方法:选择2015年1月至2016年12月中国人民解放军联勤保障部队第908医院收治的锁骨中段骨折内固定后骨不连患者13例,其中男9例,女4例,年龄19-54岁,均接受ALLOMATRIX~?注射型植骨材料治疗。术后随访12个月,根据Lane-Sandhu X射线评分评价骨折愈合质量,采用Constant评分评估肩关节功能。试验获得中国人民解放军联勤保障部队第908医院伦理委员会批准。结果与结论:①13例患者均获得骨性愈合,愈合时间8-16周,未出现感染、脱位、固定松动等并发症;②13例患者术后3个月与末次随访的Lane-Sandhu X射线评分总分均高于术前(P<0.05);③13例患者术后3个月与末次随访的肩关节功能Constant评分总分均高于术前(P<0.05);④结果表明,ALLOMATRIX~?注射型植骨材料可以用于治疗锁骨骨不连。BACKGROUND:Treatment of nonunion of clavicular fractures usually requires the insertion of bone material to facilitate bone healing.Injectable bone grafts have been successfully used in the treatment of limb fractures and lumbar fusion.However,there are few studies on its use in the treatment of nonunion.OBJECTIVE:To investigate the clinical effect of injection bone graft in the treatment of nonunion of clavicle fracture after internal fixation.METHODS:Totally 13 patients(9 males and 4 females aged 19-54 years old)with nonunion after internal fixation of clavicular fractures in the middle segment of the clavicle,who were treated in the No.908 Hospital of Joint Logistic Support Force of Chinese PLA from January 2015 to December 2016,were selected.All of them were treated with ALLOMATRIX~?injection bone graft.Postoperative follow-up was conducted for 12 months.The fracture healing quality was evaluated by Lane-Sandhu X-ray score,and the shoulder joint function was evaluated by Constant score.This experiment was approved by the Ethics Committee of No.908 Hospital of Joint Logistic Support Force of Chinese PLA.RESULTS AND CONCLUSION:(1)All the 13 patients received osseous healing,which lasted 8-16 weeks,and no complications such as infection,dislocation,or fixator loosening occurred.(2)The total Lane-Sandhu X-ray score of 13 patients at 3 months and the last follow-up was higher than that before the operation(P<0.05).(3)The total Constant score of shoulder joint function in 13 patients was higher than that before surgery at 3 months after surgery and at the last follow-up(P<0.05).(4)The results showed that ALLOMATRIX~?injection bone graft could be used to treat clavicular nonunion.

关 键 词：骨 材料 骨不连 植入物 固定 内固定 锁骨 骨折 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]