摘要
目的:探讨自固化磷酸钙人工骨(CPC)填充修复骨缺损的临床效果。方法:骨缺损94例,男59例,女35例;年龄11~72岁,平均39.4岁。骨缺损部位:胸腰椎38例,跟骨25例,胫骨15例,股骨7例,肱骨近端3例,桡骨远端5例,近节指骨1例。骨缺损原因:骨折塌陷复位后骨缺损63例,骨髓炎20例,骨囊肿6例,骨纤维异常增殖症4例,内生软骨瘤1例。骨缺损范围为1cm×1cm^4cm×20cm,用CPC填充修复,CPC充填量为3~42g,其中单纯CPC填充修复74例(胸腰椎骨折行椎体成形38例,骨折复位后空腔充填25例,良性骨肿瘤病灶刮除后充填11例),载药CPC填充修复骨髓炎20例。结果:所有患者均获随访,随访时间14~48个月,平均29.6个月。全部患者术后未见过敏或毒性反应,无皮疹或高热,血钙、磷、碱性磷酸酶均正常,切口无瘙痒感。随访时X线片显示,植入CPC与宿主骨接触紧密,界面处未见间隙存在,骨缺损处的解剖形状完全或大部分恢复,未见脱落现象,随访时部分患者CPC部分降解成骨。9例发生术后伤口渗出,为淡黄色清亮稀薄分泌物,细菌培养阴性,经换药后伤口愈合良好。结论:CPC填充修复骨缺损安全有效,并发症少,是理想的骨替代品,载药CPC是治疗骨髓炎的理想方法。
Objective： To study the clinical effects of calcium phosphate cement（CPC） in the repair of bone defects. Methods： Among 94 patients with bone defect,59 patients were male and 35 patients were female, ranging in age from 11 to 72 years, with an average of 39. 4 years. All defects were repaired with CPC. The bone defects were located as follows：thoracolumbar vertebrae in 38 patients, calcaneus in 25 patients, tibia in 15 patients, femur in 7 patients, proximal humerus in 3 patients, distal radius in 5 patients and proximal phalanx in 1 patient. The causes of bone defects were fracture in 63 patients, osteomyelitis in 20 pa- tients,bone cyst in 6 patients,fibrous dysplasia in 4 patients and enchondroma in 1 patient. The size of bone defects ranged from 1 cm × 1 cm ^- 4 cm × 20 cm. The weight of CPC packed into the bone defects ranged 3 to 42 g. Among 74 patients treated with simple CPC repair,38 patients with thoracolumbar fractures underwent vertebroplasty with calcium phosphate artificial bone,25 patients with fractures were fill with CPC at sites of defects after reduction,and 11 patients with benign tumor of bone were filled with CPC at sites of defects after curettage. Twenty patients with osteomyelitics were treated with antibiotic-loaded CPC. Results： All the 94 patients were followed-up,ranged from 14 to 48 months （average,29. 6 months）. There were no allergic or toxic reac- tion, no rush or high fever, no fluctuation of serum calcium and phosphate and alkaline phospholatase, no pruritus around the inci- sion in all patients. The X-ray examination showed that the implanted CPC was firmly bonded to the bone at the interface and the anatomic contour of the bone at the sites of defects was successfully restored ,and no ablation occurred. Degradation and new-bone formation were found in some patients. Incisions oozing light yellow fluids were found in 9 patients, bacterial culture of the fluids is negative,and then healed through dressing changes. Conclusion： CPC is safe and nontoxic,which is
出处
《中国骨伤》
CAS
2007年第6期376-378,共3页
China Journal of Orthopaedics and Traumatology
基金
义乌市科技攻关项目(编号:2006-G3-15)
关键词
磷酸钙类
骨缺损
修复外科手术
骨代用品
Calcium phosphate
Bone defects
Reconstructive surgical procedures
Bone substitutes
