同種異體皮質骨板結合鋼板治療股骨粉碎性骨折

[摘要] 目的 探討同種異體皮質骨板結合鋼板治療股骨粉碎性骨折的療效。方法 對我院收治56例股骨粉碎性骨折的臨床資料進行回顧性分析。自2007年8月以來，共收治股骨嚴重粉碎性骨折56例，全部患者采用鋼板加對側同種異體皮質骨板一體化固定。結果 56例患者全部獲得隨訪，時間為6～25個月，平均15個月，最終獲骨折愈合。X線顯示:同種異體骨板與宿主骨整合，骨折線消失。結論 同種異體皮質骨板結合鋼板治療股骨粉碎性骨折是一種有效的治療方法，移植骨板與宿主骨整合后能增加局部骨量儲備，增強股骨強度。

[關鍵詞] 同種異體骨移植;骨板;股骨骨折;鋼板

[中圖分類號] R683.42[文獻標識碼] A [文章編號] 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

近年來我院采用切開復位、同種異體皮質骨板結合鋼板一體化固定和自體松質骨移植治療股骨嚴重性粉碎性骨折，取得滿意療效。本文擬就相關臨床資料和手術進行回顧性分析。

1臨床資料

1.1一般資料

本組56例，男40例，女16例;年齡18～54歲，平均41歲。受傷原因:交通傷48例，重物砸傷6例，墜落傷2例。其中開放骨折32例，閉合骨折24例;左下肢38例，右下肢18例;骨缺損42例，無骨缺損14例。合并顱腦損傷3例，胸部損傷2例，其他部位骨折6例，休克1例。有26例開放性骨折傷口均小于5cm，行傷口清創縫合。全部患者術前均行脛骨結節骨牽引，待病情穩定、患肢腫脹基本消退后，采用同種異體皮質骨板、鋼板一體化固定結合自體松質骨移植治療。

1.2異體皮質骨板的制備

取因外傷截肢的長管狀骨，徹底去除表面的軟組織、骨膜及髓腔內組織，制成大小合適的骨板，反復生理鹽水沖洗，用雙氧水和乙醚交替浸泡行脫蛋白處理，制成同種異體皮質骨板陰干，分袋包裝，密封，再經環氧乙烷消毒后，于常溫下保存備用。……