脱钙骨基质在四肢创伤骨缺损中的应用效果研究  

Application effect of decalcified bone matrix in traumatic bone defects of limbs

作　　者：王小博 李文锋 王敖敖 张晨曦 李利 侯树勋 赵彦涛 WANG Xiao-bo;LI Wen-feng;WANG Ao-ao;ZHANG Chen-xi;LI Li;HOU Shu-xun;ZHAO Yan-tao(Senior Department of Orthopedics,the Fourth Medical Center of PLA General Hospital,Beijing,100048,China)

机构地区：[1]中国人民解放军总医院第四医学中心骨科医学部,北京100048 [2]北京市骨科植入医疗器械工程技术研究中心,100048

出　　处：《中国骨与关节杂志》2023年第12期911-916,共6页Chinese Journal of Bone and Joint

基　　金：国家自然科学基金专项(82151312);首都临床诊疗技术研究及转化应用项目(Z201100005520060)。

摘　　要：目的探讨新型脱钙骨基质(demineralized bone matrix,DBM)在四肢创伤骨缺损中的应用效果。方法回顾分析2020年1月至2021年12月,解放军总医院第四医学中心采用DBM治疗的30例四肢创伤骨缺损患者的临床资料,其中男20例,女10例;年龄18~60岁,平均44岁。骨折部位:胫骨平台骨折12例,踝关节骨折(合并关节面塌陷)8例,骨不连5例,四肢长骨骨折伴骨缺损5例。分别于术后3个月、6个月、12个月采用Lane-Sandhu X线评分评价骨愈合情况并观察并发症发生情况。结果本组随访时间3~20个月,平均11.8个月。30例均实现骨愈合,恢复良好。愈合时间10~16周,平均(12.70±1.92)周,患者术后1个月、3个月及末次随访时Lane-SandhuX线评分均高于术前,术后3个月及末次随访时Lane-Sandhu X线评分均高于术后1个月[术前(0±0),术后1个月(2.17±0.80),术后3个月(4.63±1.35),末次随访(7.30±1.29)],且差异均有统计学意义(P<0.05)。30例患者随访期间均未出现与DBM植入材料相关的不良反应,术后无一例感染、内固定及植入物松动等并发症。结论新型DBM在四肢创伤骨缺损治疗中具有较好的应用效果。Objective To retrospectively study the effect of a new decalcified bone matrix in the treatment of traumatic bone defects in extremities.Methods Thirty patients treated with decalcified bone matrix in the Fourth Medical Center of the PLA General Hospital from January 2021 to December 2021 were followed up and evaluated.The time points included 3,6,and 12 months.The bone healing and complications were evaluated.Results Thirty patients were followed up in different forms,all of them achieved bone healing and recovered well.The healing time was 10-16 weeks,with an average of(12.70±1.92)weeks.The patients’Lane Sandhu X-ray scores at 1,3 months after surgery and at the last follow-up were higher than those before surgery,and the scores at 3 months and the last follow-up were higher than those at 1 month after surgery with a statistically significant difference[Lane Sandhu X-ray scores:(0±0)preoperatively,(2.17±0.80)1 month postoperativel,(2.17±0.80)3 months postoperatively,(7.30±1.29)at the last follow-up](P<0.05).No adverse reaction related to decalcified bone matrix implants occurred in the follow-up period of 30 patients.No infection,internal fixation,implant loosening or other complications occurred after surgery.Conclusions The new decalcified bone matrix has a good effect in the treatment of traumatic bone defects in extremities.

关 键 词：骨折 骨移植 同种异体骨 骨缺损 

分 类 号：R683.4[医药卫生—骨科学]