同种异体皮质骨板结合钢板治疗股骨粉碎性骨折.doc

同种异体皮质骨板结合钢板治疗股骨粉碎性骨折[摘要] 目的 探讨同种异体皮质骨板结合钢板治疗股骨粉碎性骨折的疗效。方法 对我院收治56例股骨粉碎性骨折的临床资料进行回顾性分析。自2007年8月以来,共收治股骨严重粉碎性骨折56例,全部患者采用钢板加对侧同种异体皮质骨板一体化固定。结果 56例患者全部获得随访,时间为6～25个月,平均15个月,最终获骨折愈合。X线显示:同种异体骨板与宿主骨整合,骨折线消失。结论 同种异体皮质骨板结合钢板治疗股骨粉碎性骨折是一种有效的治疗方法,移植骨板与宿主骨整合后能增加局部骨量储备,增强股骨强度。 [关键词] 同种异体骨移植;骨板;股骨骨折;钢板 [中图分类号] R683.42[文献标识码] A [文章编号] 1673-9701(2010)04-143-02 Use of Allograft Cortical Bone Plates and Armor Plate for Reconstruction of Comminuted Fracture of Femur DING ZhenqiHU QianqinZHUANG ZeminLIU Hongqi Orthopaedic of the 175th Hospital of PLA,Zhangzhou 363000,China [Abstract] Objective To evaluate effectiveness of allograft cortical bone plate and armor plate in comminuted fracture of femur. Methods A retrospective study of 56 patients recorded in our department from 2007. All the patients were treated by allograft cortical bone plate and armor plate. Results All cases were followed up for 6 months to 25 months,the average follow up duration 15 months,all cases of bone fracture were healed,the allograft cortical bone plates is incorporated in the host bone and X-ray displaying fractional line disappeared. Conclusion the treatment of comminuted fracture of femur with allograft cortical bone plate and armor plate is a reliable treatment,and it can increase bone reservation and augment the strength of femur once the allograft strut is incorporated in the host bone. [Key words] Allograft;Bone plates;Femoral fracture;Armor plate 近年来我院采用切开复位、同种异体皮质骨板结合钢板一体化固定和自体松质骨移植治疗股骨严重性粉碎性骨折,取得满意疗效。本文拟就相关临床资料和手术进行回顾性分析。 1临床资料 1.1一般资料 本组56例,男40例,女16例;年龄18～54岁,平均41岁。受伤原因:交通伤48例,重物砸伤6例,坠落伤2例。其中开放骨折32例,闭合骨折24例;左下肢38例,右下肢18例;骨缺损42例,无骨缺损14例。合并颅脑损伤3例,胸部损伤2例,其他部位骨折6例,休克1例。有26例开放性骨折伤口均小于5cm,行伤口清创缝合。全部患者术前均行胫骨结节骨牵引,待病情稳定、患肢肿胀基本消退后,采用同种异体皮质骨板、钢板一体化固定结合自体松质骨移植治疗。 1.2异体皮质骨板的制备 取因外伤截肢的长管状骨,彻底去除表面的软组织、骨膜及髓腔内组织,制成大小合适的骨板,反复生理盐水冲洗,用双氧水和乙醚交替浸泡行脱蛋白处理,制成同种异体皮质骨板阴干,分袋包装,密封,再经环氧乙烷消毒后,于常温下保存备用。 1.3手术方法 在持续硬膜外麻醉下,采用大腿外侧纵形切口。复位骨折端、骨折端因骨块粉碎严重,不宜强行追求解剖复位以免造成骨膜剥离严重,导致骨延迟愈合甚至骨不连