可吸收纤维膜联合自体松质骨颗粒植骨治疗四肢长骨干骨缺损
魏世隽;蔡贤华;齐白文;喻爱喜;
摘要(Abstract)：
[目的]探讨应用可吸收纤维膜联合自体松质骨植骨修复四肢长骨骨缺损的方法和临床疗效。[方法]对2012年8月~2013年8月本科收治的19例四肢长骨骨缺损患者,骨缺损范围大小为1.5~5.0 cm,经创面严格清创后,给予髓内钉或钢板内固定,骨缺损区予以自体松质骨颗粒填充植骨,采用可吸收纤维膜(FibrillarTM,Tthicon LLC,USA)包绕骨缺损区,术后常规抗感染治疗。观察手术切口和骨缺损愈合情况。[结果]17例患者术后切口一期愈合。2例术后切口有少许渗出,细菌培养结果阴性,切口延期愈合;18例术后获得12~18个月的随访,平均14.3个月;17例获得完全骨性修复,愈合时间4~8个月,平均5.3个月,1例患者术后8个月仍未获得骨性愈合,给予二次植骨后4个月骨性愈合。无1例发生感染及并发骨髓炎。愈后外观及功能满意。[结论]利用市售的可吸收纤维膜联合自体松质骨颗粒植骨可以成功修复四肢长骨骨缺损。
关键词(KeyWords)： 植骨;骨缺损;可吸收性植入物
基金项目(Foundation): 武汉市中青年医学骨干人才培养工程资助项目(武卫生计生[2014]77号)
作者(Author): 魏世隽;蔡贤华;齐白文;喻爱喜;
Email:
DOI:
参考文献(References)：
- [1]Meinig RP.Clinical use of resorbable polymeric membranes in the treatment of bone defects[J].Orthop Clin North Am,2010,41(1):39-47.
- [2]Dimitriou R,Mataliotakis GI,Calori GM,et al.The role of barrier membranes for guided bone regeneration and restoration of large bone defects-current experimental and clinical evidence[J].BMC Med,2012,10(81):1-24.
- [3]Ben Amotz O,Ramirez R,Husain T,et al.Complications related to harvest of the proximal end of the fibula:a systematic review[J].Microsurgery,2014,34(8):666-669.
- [4]Sala F,Thabet AM,Castelli F,et al.Bone transport for postinfectious segmental tibial bone defects with a combined ilizarov/taylor spatial frame technique[J].J Orthop Trauma,2011,25(3):162-168.
- [5]Karargyris O,Polyzois VD,Karabinas P,et al.Papineau debridement,Ilizarov bone transport,and negative-pressure wound closure for septic bone defect of the tibia[J].Eur J Orthop Surg Traumatol,2014,24(6):1013-1017.
- [6]Aurégan JC,BéguéT.Induced membrane for treatment of critical sized bone defect:a review of experimental and clinical experiences[J].Int Orthop,2014,38(9):1971-1978.
- [7]Meinig RP,Rahn B,Perren SM,et al.Bone regeneration with resorbable polymeric membranes:treatment of diaphyseal bone defects in the rabbit radius with poly(L-lactide)membrane-A pilot study[J].J Orthop Trauma,1996,10(3):178-190.
- [8]Rakhmatia YD,Ayukawa Y,Furuhashi A,et al.Current barrier membranes:titanium mesh and other membranes for guided bone regeneration in dental applications[J].J Prosthodont Res,2013,57(1):3-14.