异种骨基质明胶复合带锁髓内钉治疗术后骨折愈合障碍  

The treatment of postoperative fracture union disorder by the combination of heterogeneous bone matrix gelatin and cross-lock intramedullary nail

作　　者：陈剑飞[1] 林坚平[1] 马业涛[1] 姚伦龙[1] 张光强[1] 张熙民 

机构地区：[1]海南省人民医院创伤骨科,海南海口570311

出　　处：《海南医学》2004年第4期11-13,共3页Hainan Medical Journal

基　　金：国家自然科学基金资助项目 (编号 :3 9860 0 75 3 95 60 0 80 )

摘　　要：目的　探讨异种骨基质明胶 (bonemartrixgelatin ,BMG)复合带锁髓内钉治疗骨折愈合障碍的可行性。方法　 2 6例骨折愈合障碍取内固定时 ,在骨折端凿少许骨质做组织切片 ,用带锁髓内钉固定 ,骨折端周围植入异种BMG。 2 0例于术前、术后 1周、术后 2周检测转化生长因子 -β1 (transforminggrowthfactorbetaⅠ ,TGF -β1 )、监测异种BMG的成骨活性。结果　 2 6例伤口甲级愈合 ;骨组织切片示骨折断端骨陷窝内骨细胞消失 ;术后 3 -6个月开始负重行走 ,术后 8-12个月骨折均获愈合 ;TGF -β1 术前与术后比较 ,差异有显著意义 (P <0 .0 1)。结论　带锁髓内钉固定是治疗骨折愈合障碍的最好选择 ;异种BMG可促进骨折愈合 ,可替代自体植骨。Objective To investigate the possibility of treatment of fracture union disorder by the combination of bone matrix gelatin (BMG) and cross-lock intramedullary nail.Methods When the internal fixations of 26 cases of fracture union disorder were extracted,little bone tissue was taken out to be tissue slice at the site of fracture.After the cross-lock nail had already been applied to fixate,BMG was implanted.The antigen and immunoreaction of heterogeneous BMG were supervised in 20 cases through the detections of following cytokines pre-operation?one-week post-operation and two-week post-operation:Transforming growth factor beta Ⅰ (TGF-β 1).Results The incisions of 26 cases were union in the first rate;the bone tissue slice showed the osteocytes in osteo-lacuna at the end of fracture were disappeared;the patients began to walk with weight loading 3-6 months post-operation,and fracture union were acquired 8-12 months post-operation;there were significant differences (P<0.01) of TGF-β 1.Conclusions The best choice of treatment of fracture union disorder is cross-lock intramedullary nail;heterogeneous BMG can replace auto-bone graft to facilitate fracture union.

关 键 词：异种骨基质明胶 复合带锁髓内钉 治疗 术后 骨折愈合障碍 

分 类 号：R683[医药卫生—骨科学] R687.33[医药卫生—外科学]