解琛;蔡锦方;

• 1:济南军区总医院(第二军医大学济南临床医学院)骨创伤外科

摘要(Abstract)：

[目的]对不带血运的自体骨移植物临床应用现状及进展相关内容进行文献综述,深入了解该领域的前沿动态。[方法]通过Pubmed数据库及中国知网数据库等检索工具对近年来发表的与不带血运自体骨移植物相关的文献进行检索,对检索结果筛选后仔细阅读并进行总结分析。[结果]与异体及人工骨移植相比,不带血运的自体骨移植物兼具骨传导、骨诱导、骨生成三大要素,成骨效能高,且可以避免疾病传播的风险。缺点是骨量有限,可能无法完全满足大范围植骨的需要。与带血运的自体移植物相比,其再血管化的过程及愈合的过程相对较慢,但远期效果良好,而且手术中可以不必考虑血管蒂的影响,可以应对更多的变化。[结论]不带血运的自体骨移植物作为一种传统的骨移植技术在临床上已经应用了相当长的时间,技术成熟,疗效确切。在计算机辅助技术和新的固定材料及装置迅速发展的推动下,这一传统的技术和新兴的技术有机的结合,在未来会有进一步的发展。

关键词(KeyWords)： 不带血运骨移植物;修复重建;骨缺损;骨髓炎

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 解琛;蔡锦方;

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DOI:

参考文献(References)：

• [1]Williams A,Szabo RM.Bone transplantation[J].Orthopedics,2004,5:488-495.
• [2]宋会平,王志强.骨移植的过去现在和未来[J].中国修复重建外科杂志,2009,5:513-516.
• [3]马武秀,程迅生.自体骨移植修复骨缺损的研究进展[J].中国骨与关节损伤杂志,2011,6:574-576.
• [4]Christopher G,Finkemeier.Bone-grafting and bone-graft substitutes[J].J Bone Joint Surg Am,2002,3:454-464.
• [5]Axhausen W.The osteogenetic phases of regeneration of bone.A historical and experimental study[J].J Bone Joint Surg Am,1956,38:593-600.
• [6]Gray JC,Elves MW.Early osteogenesis in compact bone isografts:a quantitative study of contributions of the different graft cells[J].Calcif Tissue Int,1979,29:225-237.
• [7]Burwell RG.Studies in the transplantation of bone.Ⅶ.The fresh composite homograft autograft of cancellous bone.An analysis of factors leading to osteogenesis in marrow transplants and in marrowcontaining bone grafts[J].J Bone Joint Surg Br,1964,46:110-140.
• [8]Gazdag AR,Lane JM,Glaser D,et al.Alternatives to autogenous bone graft:efficacy and indications[J].J Am Acad Orthop Surg,1995,3:1-8.
• [9]Dell PC,Burchardt H,Glowczewskie FP Jr.A roentgenographic,biomechanical,and histological evaluation of vascularized and non-vascularized segmental fibular canine autografts[J].J Bone Joint Surg Am,1985,67:105-112.
• [10]Tang CL,Mahoney JL,McKee MD,et al.Donor site morbidity following vascularized fibular grafting[J].Microsurgery,1998,6:383-386.
• [11]Masqueleta AC,Benkoa PE,et al.Harvest of cortico-cancellous intramedullary femoral bone graft using the reamer-irrigator-aspirator(RIA)[J].Orthop Traumatol Surg Res,2012,98:227-232.
• [12]Green J.History and development of suction-irrigation-reaming[J].Injury,2010,2:24-31.
• [13]Husebye EE,Lyberg T,Madsen JE,et al.The influence of one step reamer-irrigator-aspirator technique on the intramedullary pressure in the pig femur[J].Injury,2006,37:935-940.
• [14]Higgins TF,Casey V,Bachus K.Cortical heat generation using an irrigating/aspirating single pass reaming vs.conventional stepwise reaming[J].J Orthop Trauma,2007,21:192-197.
• [15]Hammer TO,Wieling R,Green JM.Effects of re-implanted particles from intramedullary reaming on mechanical properties and callus formation.A laboratory study[J].J Bone Joint Surg Br,2007,89:1534-1538.
• [16]Hak DJ,Pittman JL.Biological rationale for the intramedullary canal as a source of autograft material[J].Orthop Clin N Am,2010,41:57-61.
• [17]Stafford PR,Norris BL.Reamer-irrigator-aspirator bone graft and bi Masquelet technique for segmental bone defect nonunions:a review of 25 cases[J].Injury,2010,2:72-77.
• [18]McCall TA,Brokaw DS,Jelen BA,et al.Treatment of large segmental bone defects with reamer-irrigator-aspirator bone graft:technique and case series[J].Orthop Clin North Am,2010,1:63-73.
• [19]Gadre PK,Ramanojam S,Patankar A.Nonvascularized bone grafting for mandibular reconstruction:myth or reality[J].J Craniofac Surg,2011,5:1727-1735.
• [20]Pogrel MA.A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects[J].J Oral Maxillofac Surg,1997,11:1200-1206.
• [21]Foley BD,Thayer WP,Honeybrook A.Mandibular reconstruction using computer-aided design and computer-aided manufacturing:an analysis of surgical results[J].J Oral Maxillofac Surg,2013,2:111-119.
• [22]Behnia H,Homayoun S,Qaranizade K.Multidisciplinary reconstruction of a palatomaxillary defect with nonvascularized fibula bone graft and distraction osteogenesis[J].J Craniofac Surg,2013,2:186-190.
• [23]Noellert RG,Louis DS,Arbor A.Long-term follow-up of nonvascularized fibular autografts for distal radial reconstruction[J].J Hand Surg,1985,10:335-340.
• [24]Robert E,Falls DS.Nonvascularized fibular autograft to treat recurrent giant cell tumor of the distal radius[J].J Hand Surg,1988,13:671-675.
• [25]Patwardhan S,Shyam AK,Mody RA.Reconstruction of bone defects after osteomyelitis with nonvascularized fibular graft:a retrospective study in twenty-six children[J].J Bone Joint Surg Am,2013,95:1-6.
• [26]Gao K,Gao W,Huang JH.Treatment of surgical neck nonunions of the humerus with locked plate and autologous fibular strut graft[J].Med Princ Pract,2012,21:483-487.
• [27]Plakseychuk AY,Kim SY,Park BC,et al.Vascularized compared with nonvascularized fibular grafting for the treatment of osteonecrosis of the femoral head[J].J Bone Joint Surg Am,2003,4:589-596.9741
• [28]Kim SY,Kim YG,Kim PT,et al.Vascularized compared with nonvascularized fibular grafts for large osteonecrotic lesions of the femoral head.[J]J Bone Joint Surg Am,2005,9:2012-2018.
• [29]Tetik C,Ba爧ar H,Bezer M,et al.Comparison of early results of vascularized and non-vascularized fibular grafting in the treatment of osteonecrosis of the femoral head[J].Acta Orthop Traumatol Turc,2011,5:326-334.
• [30]Nassr A,Khan MH,Ali MH,et al.Donor-site complications of autogenous nonvascularized fibula strut graft harvest for anterior cervical corpectomy and fusion surgery experience with 163 consecutive cases[J].Spine,2009,11:893-898.
• [31]胡学信,陈一心,陈晖.同种异体骨和自体骨移植在胫骨平台骨折中的应用[J].中国矫形外科杂志,2006,4:245-248.
• [32]Jeong ST,Park HB,Hwang SC,et al.Use of intramedullary nonvascularized fibular graft with external fixation for revisional charcot ankle fusion:a case report[J].J Foot Ankle Surg,2012,51:249-253.