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  • 蒋国华1,周富根1,吴永发2,曹烈虎2,禹宝庆2,李明2,马玉海2,王心玲3,苏佳灿2*,吴永发.纳米人工骨在Schaterzker Ⅱ~Ⅲ型胫骨平台骨折解剖形态重建中的应用[J].第二军医大学学报,2010,31(6):646-649    [点击复制]
  • JIANG Guo-hua1, ZHOU Fu-gen1, WU Yong-fa2, CAO Lie-hu2, YU Bao-qing2, LI Ming2, MA Yu-hai2, WANG Xin-ling3, SU Jia-can2*,吴永发.Supportive plate combined with nano-artificial bone in anatomic reconstruction of Schaterzker Ⅱ-Ⅲ tibial plateau fracture[J].Acad J Sec Mil Med Univ,2010,31(6):646-649   [点击复制]
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纳米人工骨在Schaterzker Ⅱ~Ⅲ型胫骨平台骨折解剖形态重建中的应用
蒋国华1,周富根1,吴永发2,曹烈虎2,禹宝庆2,李明2,马玉海2,王心玲3,苏佳灿2*,吴永发
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(1.浙江省嘉善县第一人民医院外二科,嘉兴 314100;2.第二军医大学长海医院骨科,上海 200433;3.中国人民解放军总后勤部第一门诊部,北京 100842)
摘要:
目的观察纳米人工骨结合支持钢板手术重建Schaterzker Ⅱ~Ⅲ型胫骨平台骨折的疗效。方法对33例Schaterzker Ⅱ~Ⅲ型胫骨平台骨折患者采用纳米人工骨结合支持钢板手术重建。全部病例术前均行正侧位摄片、CT扫描及三维重建,以准确了解骨折塌陷和粉碎程度及骨折碎片的翻转方向。凡骨折塌陷>3 mm,且伤前无关节退行性变者,均作为该手术方法的适应证。结果除 1 例Ⅲ型严重粉碎性骨折术后8个月发生高度丢失,平台复位效果不佳外,术后X线片显示其余所有骨折均达到解剖复位或接近解剖复位。经 6个月至2.5年\[平均(1.5±0.6)年\]的X线片和功能随访,维持解剖复位者28例(占85.7%);按Merchant评分标准评定膝关节功能优良29例(87.9%)。结论纳米人工骨结合支撑钢板手术重建Schaterzker Ⅱ~Ⅲ型胫骨平台骨折能有效避免复位后的再丢失,改善远期疗效;纳米人工骨作为骨移植替代材料,具有良好的临床应用前景。
关键词:  胫骨骨折  纳米人工骨  支持钢板
DOI:10.3724/SP.J.1008.2010.0646
投稿时间:2010-02-04修订日期:2010-06-05
基金项目:上海市科委纳米专项基金(0852nm04300),上海市卫生局中医药专项基金(2009S018),上海市人事专项基金(2009003).
Supportive plate combined with nano-artificial bone in anatomic reconstruction of Schaterzker Ⅱ-Ⅲ tibial plateau fracture
JIANG Guo-hua1, ZHOU Fu-gen1, WU Yong-fa2, CAO Lie-hu2, YU Bao-qing2, LI Ming2, MA Yu-hai2, WANG Xin-ling3, SU Jia-can2*,吴永发
(1. Second Department of Surgery, the First People’s Hospital of Jiashan, Jiaxing 314100, Zhejiang, China; 2. Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China; 3. The First Out-patient Department, General Logistics Department of PLA, Beijing 100842, China)
Abstract:
ObjectiveTo observe the therapeutic effect of supportive plate combined with nano-artificial bone in treatment of Schaterzker Ⅱ-Ⅲ tibial plateau fracture. MethodsThirty-three patients with Schaterzker Ⅱ-Ⅲ tibial plateau fracture were treated with supportive plate combined with nano-artificial bone (Shanghai Rebone Biomaterials Co., Ltd). All the patients received X-ray film, CT scan and 3D reconstruction to accurately detect the degree of fracture collapse and the direction of bone chips before operation. If the fracture collapse of tibial plateau was more than 3 mm and there was no degeneration of the joint, the patients could be treated with supportive plate combined with nano-artificial bone. ResultsThe postoperation X-ray films showed that all patients achieved complete or nearly anatomic reduction, except that one patient with severe Schaterzker Ⅲ comminuted fracture had height loss 8 months after operation and the result of plateau repair was not satisfactory. The patients were followed up for 6 months to 2.5 years (a mean of \[1.5±0.6\] years) and 28 (85.7%) patients maintained in complete or nearly anatomic reduction. Twenty-nine (87.9%)patients obtained good to excellent knee fucntion according to the Merchan Knee Functional Score. ConclusionSupportive plate combined with nano-artificial bone is a safe and effective treatment for Schaterzker Ⅱ-Ⅲ tibial plateau fracture, and it can avoid reduction loss and improve the long term outcomes of patients. Nano-artificial bone as a bone graft material has a bright future in clinic.
Key words:  tibial fracture  nano-artificial bone  supportive plate