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纳米人工骨与自体髂骨植骨治疗桡骨远端不稳定性C型骨折的疗效对比
张中伟1,年申生2,曹烈虎2*,吴永发2,马玉海1,苏佳灿2
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(1. 嘉兴市第二人民医院骨科, 嘉兴 314300;2. 第二军医大学长海医院骨科,上海 200433)
摘要:
目的 对比观察组纳米人工骨与自体髂骨植骨不稳定性AO-C型桡骨远端骨折的临床疗效。 方法 自2006年6月至2008年6月,选择需要植骨的桡骨远端不稳定性C型骨折65例,纳米人工骨组,35例,自体髂骨组30例,采用常规手术切开复位内固定。术后骨科常规处理。对比观察手术耗时、出血量、引流量及伤口愈合情况。术后1、2、3、6个月、1年、2年、3年行X线摄片观察骨愈合情况。 结果 两组患者均获随访,随访时间1~3年,平均2.2年。两组比较,纳米人工组在手术时间、出血量明显少于自体髂骨组,具有统计学差异,两组住院天数、血清钙磷的水平检测在术后1周、1月、3月、6月未见明显差异。所有患者术后观察均未见伤口破溃、红肿及其它炎性反应,未见任何排斥反应,。依据Gartland和Werley的功能评分系统,纳米人工组优18例,良12例,一般3例,差2例,优良率85.7%;自体髂骨组优17例,良9例,一般2例,差1例,优良率86.7%。 结论 纳米人工骨结合支持钢板治疗不稳定性桡骨远端骨折,能有效避免骨折复位后的再丢失,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:  骨折  髂骨  纳米人工骨  骨移植
DOI:10.3724/SP.J.1008.2011.0696
投稿时间:2011-02-26修订日期:2011-05-05
基金项目:中国博士后科研基金(20100470756),上海博士后基金(11r21412700).
Nano-artificial bone and iliac autograft for unstable C type distal radius fracture: a comparison of efficacies
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Abstract:
Obiective To compare the effects of nanometer artificial bone versus iliac autograft in treatment of unstable C type collapse distal radius fracture. Method Between June 2006 and June 2008, 65 patients suffered unstable C type collapse distal radius fracture were involved in this study, including 35 patients with nanometer artificial bone treatment and 30patients with iliac autograft bone. Operation time, blood loss, drainage and wound healing were compared in each group. X-ray was took in1, 2, 3, 6, 12, 24 and 36 months after operation. Results Two groups of patients were followed up for 1 to 3 years, an average of 2.2 years. For operation time and blood loss, the nanometer artificial bone group was significantly less than the iliac autogenous group (P<0.05). There was no difference in days of hospitalization, level of serum calcium and phosphorus levels between the two groups. According to Gartland and Werley score, there were excellent in 8 cases, good in 12 cases, general in 3 cases and 4 poor cases for the group of nanometer artificial bone treatment,excellent and good rate was 85.7%.In the other group, there were excellent in 17 cases, good in 9 cases, general in 2 cases and 1 poor cases,excellent and good rate was 86.7%. Conclusion The combination of nanometer artificial bone with plate fixation for treatment of unstable C type collapse distal radius fracture can prevent bone loss after fracture reduction effectively. As a bone graft substitute, nanometer artificial bone has a good prospect for clinical application.
Key words:  Distal radius fractures  nanometer artificial bone  graft