磷酸钙活性人工骨与自体骨颗粒环抱式植骨治疗四肢骨不连#br#

doi:10.13418/j.issn.1001-165x.2020.02.020

中国临床解剖学杂志 ›› 2020, Vol. 38 ›› Issue (2): 202-207.doi: 10.13418/j.issn.1001-165x.2020.02.020

磷酸钙活性人工骨与自体骨颗粒环抱式植骨治疗四肢骨不连#br#

吴浩俊¹，　谭荣雄¹，　何艳霞²，　陈航¹，　刘衍志³，　林瀚¹，　魏波¹，　郑越瑜¹

广东医科大学附属医院　1.骨科中心；　2.手术室；　3.天然药物研究与开发重点实验室，湛江 524001

收稿日期:2019-06-27 出版日期:2020-03-25 发布日期:2020-04-01
通讯作者: 陈航，主任医师，E-mail:Chenhang930@126.com
作者简介:吴浩俊（1980-），副主任医师，研究方向：创伤骨科基础与临床，E-mail：wuhaojun2000@126.com
基金资助:
湛江市财政竞争性项目(2016A01012，2017A01021)

RhBMP-2-loaded calcium phosphate cement scaffold combined with autogenous bone grafting in the treatment of limbs nonunion

WU Hao-jun¹, Tan Rong-xiong¹，HE Yan-xia², CHEN Hang¹, LIU Yan-Zhi³, LIN Han¹, WEI Bo¹, ZHENG Yue-yu¹

1. Department of Orthopedics; 2. Operation room; The Affiliated Hospital of Guangdong Medical University, 3.Guangdong Key Laboratory for Research and Development of Natural Drugs, Guangdong Medical University, Zhanjiang 524001, China

Received:2019-06-27 Online:2020-03-25 Published:2020-04-01

摘要/Abstract

摘要： 目的　探讨固化型磷酸钙活性人工骨(CPC/rhBMP-2)与自体骨颗粒环抱式植骨治疗四肢非感染性萎缩型骨不连的临床疗效。方法　对2013年9月至2017年9月年间治疗的16例四肢非感染性萎缩型骨不连患者进行回顾性分析，其中男12例，女4例；年龄（37.06±16.31）岁（16~67岁）。骨不连部位：下肢11例（胫骨6例、股骨3例、跟骨1例、腓骨1例），上肢5例（桡骨3例、锁骨1例、手舟骨1例），所有患者均行断端新鲜化，骨缺损中央植入自体骨颗粒，外周植入CPC/rhBMP-2形成环抱式植骨。术后复查X线片观察骨折愈合情况，记录并发症发生情况，随访患者直到骨折愈合。采用上肢功能障碍评定量表（DASH）、下肢功能量表(LEFS)和SF-12生活质量量表对治疗前、后进行疗效评定。结果　本组16例均获随访，随访时间（16.93±4.06）月（12~26月）。X片显示全部病例均获得骨性愈合，愈合时间（5.43±2.25）月（3~10月）；术后DASH、LEFS和SF-12评分与术前比较均有统计学差异(P<0.05)。结论　固化型磷酸钙活性人工骨(CPC/rhBMP-2)和自体骨颗粒环抱式植骨治疗四肢萎缩型骨不连的愈合率及安全性高，疗效可靠。

关键词: , 自体植骨, 　萎缩型骨不连, 　骨诱导膜, 　磷酸钙, 　骨形态发生蛋白

Abstract: Objective　To investigate the clinical effect of recombinant human bone morphogenetic protein 2(CPC/rhBMP-2)-loaded calcium phosphate cement scaffold combined with autogenous bone graft in the treatment of non-infectious atrophy type limbs nonunion.　Methods　A total of 16 patients (12 males, 4 females; aged from 16ys to 67ys, mean age: 37.06±16.31 ys) with limbs nonunion after surgical treatment of fractures from September 2013 to September 2017 were analyzed retrospectively. Bone nonunion part were lower limbs (tibia 5 cases, femur 3 cases, calcaneus 1 case, fibula 1 case) and upper limbs (radius 3 cases, clavicle 1 case, scaphoid 1 case). All patients were treated with CPC/rhBMP-2 scaffold combined with autogenous bone grafting in the center of bone defect. Follow-up patients were treated with X-ray to observe the fractures healing after operation and record the complication till fractures healed. Upper extremity dysfunction assessment scale (DASH), lower extremity function scale (LEFS) and SF-12 quality of life scale were used to evaluate the effect pre- and post-treatment.　Results　Mean follow-up period was 16.93±4.06 months (ranged from 12 to 26 months). X-ray film showed that all fractures were healed, healing time was 3~10 months (mean 5.43±2.25 months). There were statistical difference between preoperative and postoperative DASH, LEFS and SF-12 scale (P<0.05).　Conclusions　CPC/rhBMP-2 combined with autogenous bone graft are effective and safe in the treatment of non-infectious atrophy type limbs nonunion.

Key words: Autogenous bone grafting, , , Atrophic nonunion, 　Osteoinductive membrane, , , Calcium phosphate, , , Bone morphogenetic protein

中图分类号:

吴浩俊, 谭荣雄, 何艳霞, 陈航, 刘衍志, 林瀚, 魏波, 郑越瑜. 磷酸钙活性人工骨与自体骨颗粒环抱式植骨治疗四肢骨不连#br#[J]. 中国临床解剖学杂志, 2020, 38(2): 202-207.

WU Hao-jun, Tan Rong-xiong, HE Yan-xia, CHEN Hang, LIU Yan-Zhi, LIN Han, WEI Bo, ZHENG Yue-yu. RhBMP-2-loaded calcium phosphate cement scaffold combined with autogenous bone grafting in the treatment of limbs nonunion [J]. Chinese Journal of Clinical Anatomy, 2020, 38(2): 202-207.

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磷酸钙活性人工骨与自体骨颗粒环抱式植骨治疗四肢骨不连#br#

RhBMP-2-loaded calcium phosphate cement scaffold combined with autogenous bone grafting in the treatment of limbs nonunion

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