钛网包裹打压植骨修复大段骨缺损初步报告

doi:10.13418/j.issn.1001-165x.2015

中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (1): 101-104.doi: 10.13418/j.issn.1001-165x.2015

钛网包裹打压植骨修复大段骨缺损初步报告

殷渠东，顾三军，孙振中，马运宏

无锡市第九人民医院骨科, 江苏无锡 214062

收稿日期:2014-01-23 出版日期:2015-01-25 发布日期:2015-02-12
作者简介:殷渠东（1965-），男，四川省人，博士，主任医师，主要从事创伤骨科研究，Tel:13179680065

Preliminary report of wrapped impacted bone graft using titanium mesh for repair of large segmental bone defect

YIN Qu-dong, GU San-jun, SUN Zhen-zhong， MA Yun-hong

Department of Orthopaedics, Wuxi No. 9 People’s Hospital, Jiangsu 214062, China

Received:2014-01-23 Online:2015-01-25 Published:2015-02-12

摘要/Abstract

摘要：

目的　探讨钛网包裹打压植骨修复大段骨缺损的初步治疗效果。方法 2009年1月~2012年12月,采用钛网包裹打压植骨修复6例长骨骨折后大段骨缺损。骨折骨缺损部位：股骨和肱骨各1例，胫骨、桡骨各2例。骨缺损长度5.2～9.0 cm，平均6.5 cm。固定方法：髓内钉2例，钢板4例。合并肌腱神经损伤2例。在双侧髂后部或和髂前部等处切取骨缺损体积2倍以上大量松质骨，用钛网包裹骨缺损处两端，将颗粒状骨打压植于钛网内。骨缺损恢复长度5.2～9.0 cm，平均6.3cm。结果切口均Ｉ期愈合。术后随访12～46个月，平均18个月，骨缺损处均骨性愈合，临床愈合时间4.0～6.5个月，平均5.1个月，无固定物松动断裂；至末次随访，临近关节活动度：优1例、良4例、可1例。结论钛网包裹打压植骨修复大段骨缺损，具有简便、安全、临床愈合较快、效果良好等优点。

关键词: 大段骨缺损, 长骨, 包裹打压植骨, 钛网

Abstract:

Objective　To investigate the preliminary outcomes of wrapped impacted bone graft using titanium mesh for repair of large segmental bone defect. Methods From January 2009 to December 2012,6 cases of large segmental bone defect of lone bone after fractures were treated with wrapped impacted bone graft using titanium mesh to repair the defect. The location of fracture and defect:1 respective casein femur and humerus，2 respective cases in tibia and radius.The length of bone defect was from 5.2 cm to 9.0 cm with an average of 6.5cm.Fixation methods: intramedullary nail was used in 2 cases and plate in 4 cases.collateral injuries such as tendon or nerve injury could be foundin 2 cases. Cancellous bone with a volume two times than the defect bone was harvested from theposterior or/and anterior segments of the bilateral ilium etc. Titanium mesh was used and placed to wrap the defect, then the bone granules was impacted closely into the titanium mesh.The recovered length of bone defect was from 5.2 cm to 9.0 cm with an average of 6.3 cm. Results Incisions underwent primary healing. Following-up ranging from 12 to 46 months, with an average of 18 months,revealed that all fractures with bone defects healed; the clinical healing time ranged from 4.0 months to 6.5 months with an average of 5.1 months. no breakingor loosening of the fixator was noted.at the last follow-up,the function of the adjacent joints was excellent in 1 case, good in 4 cases and fair in 1 case. Conclusion Wrapped impacted bone graft using titanium mesh for repair of large segmental bone defect has advantages of bing simple, safe, fast in healing and excellent in efficacy.

Key words: Large segmental bone defect, Long bone, Wrapped impacted bone graft, Titanium mesh

中图分类号:

R683

殷渠东, 顾三军, 孙振中, 马运宏. 钛网包裹打压植骨修复大段骨缺损初步报告[J]. 中国临床解剖学杂志, 2015, 33(1): 101-104.

YAN Ju-Dong, GU San-Jun, SUN Zhen-Zhong, MA Yun-Hong. Preliminary report of wrapped impacted bone graft using titanium mesh for repair of large segmental bone defect[J]. Chinese Journal Of Clinical Anatomy, 2015, 33(1): 101-104.

参考文献

[1] 徐永清，朱跃良，范新宇，等. 二处截骨骨搬移治疗胫骨大段骨缺损合并软组织缺损
[J].中华创伤骨科杂志, 2012,14(10):831-834.

[2] 吴小春，韩为，路晓，等.骨运输术治疗胫骨大段骨缺损11例
[J].江苏医药, 2011, 37(11):1336-1337.

[3] 许勇，朱立新，田京，等.可注射性纳米羟基磷灰石、壳聚糖复合材料修复骨缺损的实验研究
[J].中国临床解剖学杂志, 2009,27(6):712-715.

[4] 殷渠东，顾三军，吴永伟，等.钛网包裹自体松质骨打压植骨修复桡骨节段缺损一例
[J].中国修复重建外科杂志, 2013,27(2):247-248.

[5] 刘阳，朱立新，王庆波，等.可注射性nHA/CS-BMSCs复合物修复兔股骨缺损的实验研究
[J].中国临床解剖学杂志, 2010, 28(4):421-424.

[6] 何博，黄擘，姜曙祥，等.大段同种异体骨移植二期重建修复股骨开放性骨折伴骨缺损
[J].中国矫形外科杂志, 2010, 18(16):1386-1388.

[7] 姚雨，徐本明，鹿洪辉.应用腓骨组织瓣联合治疗胫骨骨髓炎长段骨缺损20例报告
[J].中国矫形外科杂志.2007,15(20):79-80.

[8] 殷渠东，顾三军，孙振中，等.钛网打压植骨重建四肢长骨节段骨缺损
[J].    中国组织工程研究, 2012,16(48):9096-9100.

[9] Masquelet AC,Fitoussi F,Begue T,et al. Reconstruction of the long     bones by the induced membrane and spongy autograft
[J].Ann Chir Plast     Esthet,2000,45(3):346-353.

[10] Cobos JA，Lindsey RW，Gugala Z.The cylindrical titanium mesh cage for treatment of a long bone segmental defect: description of a new technique and report of two cases
[J].J Orthop Trauma, 2000, 14(1):54-59.

[11]Giannoudis PV,Faour O,Goff T,et al.Masquelet technique for the treatment of bone defects: tips-tricks and future directions
[J].Injury, 2011,42(6):591-598.

[12]Karger C,Kishi T,Schneider L,et al.Treatment of posttraumatic bone defects by the induced membrane technique
[J].Orthop Traumatol Surg Res,2012,98(1):97-102.

[13]Segal U，Shani J.Surgical management of large segmental femoral and radial bone defects in a dog: through use of a cylindrical titanium mesh cage and a cancellous bone graft
[J].Vet Comp Orthop Traumatol,    2010，23(1):66-70.

[14]Attias N，Lindsey RW.Case reports: management of large segmental tibial defects using a cylindrical mesh cage
[J].Clin Orthop Relat Res,2006,(450):259-266.

[15]Ostermann PA, Haase N,Rübberdt A,et al.Management of a long segmental defect at the proximal meta-diaphyseal junction of the tibia using a cylindrical titanium mesh cage
[J].J Orthop Trauma, 2002,16(8): 597-601.

[16]Clements JR，Carpenter BB，Pourciau JK.Treating segmental bone defects: a new technique
[J].J Foot Ankle Surg,2008,47(4):350-356.

钛网包裹打压植骨修复大段骨缺损初步报告

Preliminary report of wrapped impacted bone graft using titanium mesh for repair of large segmental bone defect

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