摘要
目的:观察胫骨平台粉碎性骨折内固定治疗中采用磷酸三钙多孔生物陶瓷植骨后的组织学变化。方法:自2004-01/2007-01于上海交通大学瑞金医院集团闵行医院骨科收治胫骨平台粉碎性骨折患者34例,其中男19例,女15例;年龄24～65岁;骨折类型按Schatzker分型:Ⅱ型7例,Ⅲ型12例,Ⅳ型6例,Ⅴ型6例,Ⅵ型3例。进行切开撬拨复位、磷酸三钙多孔生物陶瓷植骨、接骨板内固定治疗。结果:34例患者随访12～28个月,平台塌陷部分均解剖复位,其下所植磷酸三钙多孔生物陶瓷材料3～6个月后逐渐与自体相邻骨密度接近,显示逐渐被自体骨替代,无再塌陷发生,无排异渗出、感染等发生。取内固定的同时,植骨区骨组织组织学观察可见材料部分溶解,成骨细胞分泌大量骨基质包埋其中,形成骨陷窝,出现大量新生骨小梁,骨小梁之间形成骨髓腔。结论:磷酸三钙多孔生物陶瓷具有良好的生物相容性和骨传导作用,影像学观察、组织学观察均显示其生物降解效应与骨组织的改建塑性基本同步。
OBJECTIVE： To evaluate the clinical result of porous tricalcium phosphate as substitutes for cancellous bone grafts in treating comminuted tibial plateau fracture.
METHODS： Thirty-four cases with comminuted tibial plateau fracture received treatment at the Department of Orthopaedics, Minhang Hospital of Ruijin Hospital Groups, Shanghai Jiao Tong University from January 2004 to January 2007 were studied, including 19 males, 15 females, aged 24 65 years. According to Schatzker fracture classification： 7 cases with type Ⅱ, 12 cases with type Ⅲ, 6 cases with type Ⅳ, 6 cases with type Ⅴ, and 3 cases with type Ⅵ. All cases were treated with Kirschner wires poking reduction, cancellous bone grafts, and plate fixation operation. RESULTS： All patients were included in a 12-18 months followed up. The collapsed articular fragments had been anatomical reduced. The tricalcium phosphate was replaced by autogenous bone creepingwith out re-collapse of articular surface, rejection or infection occurred at 3-6 months after operation. When internal fixation was removed, histological manifestations showed that tricalcium phosphate was partly dissolved, embed with bone matrix osteoblast and newly trabeculae was formed, cavitas medullaris could be seen intertrabecular space. CONCLUSION： Tricalcium phosphate has good bio-compatibility and bone conduction effect, Image observe and histological observe shows that the biological degradation effect of tricalcium phosphate is synchronized with bone tissue reconstruction.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第21期4165-4168,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
