中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (21): 3907-3910.doi: 10.3969/j.issn.1673-8225.2010.21.025

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

不同植入材料治疗陈旧性腕舟骨骨折

王  培，李  哲，李淑英，闫洪伟   

  1. 承德医学院附属医院骨一科，河北省承德市  067000
  • 出版日期:2010-05-21 发布日期:2010-05-21
  • 通讯作者: 闫洪伟，承德医学院附属医院骨一科，河北省承德市 067000
  • 作者简介:王 培★，男，1975年生，汉族，硕士，主治医师，主要从事手足外科及创伤方面的研究。 cdgkwp@sina.com

Treating old scaphoid fractures using different implant materials

Wang Pei, Li Zhe, Li Shu-ying, Yan Hong-wei   

  1. First Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde  067000, Hebei Province, China
  • Online:2010-05-21 Published:2010-05-21
  • Contact: Yan Hong-wei, First Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China
  • About author:Wang Pei★, Master, Attending physician, First Department of Orthopedics, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China cdgkwp@sina.com

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624

被引次数

9

摘要：

目的：对不同植入材料治疗腕舟骨骨折的方法和进展进行归纳总结。
方法：第一作者应用计算机检索PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed)及CNKI数据库(www.cnki.net/index.htm)，在标题和摘要中以“陈旧性，腕舟骨，治疗”或“Carpal bone，fracture ununited”为检索词进行检索。选择文章与检索关键词材料学特点、生物相容性及其应用效果相关，同一领域文献则选择近期发表或发表在权威杂志文章。共纳入25篇文献。
结果：早期的临床工作中应用石膏管型固定腕关节来治疗，由于固定范围较大，时间较长，且固定效果欠佳，所以术后腕关节活动度的恢复会受到一定的影响，后来采用带有血液供应的骨瓣、骨膜移植技术治疗腕舟骨陈旧性不愈合，并加用克氏针、herbert钉、空心螺钉等内固定材料，取得了较为满意的疗效；随着生物技术的发展，在前人工作的基础上，含有骨形态发生蛋白的骨材料开始应用于临床，取得了令人满意的疗效。
结论：目前治疗腕舟骨骨折的各种带血管蒂的骨瓣移植术式均可取得较为满意的疗效；应用骨形态发生蛋白/纤维蛋白复合物辅助治疗可取得更加的疗效，可应用于临床，远期使用骨膜包绕肌腱-松质骨匀浆复合体替代舟骨可作为未来的一个治疗方向。

关键词: 腕舟骨, 骨折不愈合, 植入材料, 骨瓣, 内固定材料

Abstract:

OBJECTIVE: To summarize the methods and research progress of treating old scaphoid fractures using different implant materials.
METHODS: The PubMed database and CNKI database were searched by the first author using key words of “Carpal bone, fracture ununited” in title and abstract items. Papers related to material characteristics, biocompatibility and application results related to this paper were selected. In the same field, articles published in the near future or selected from authoritative journals were included. A total of 25 documents were selected.
RESULTS: Plaster cast was used to fix scaphoid fractures at early clinical works, however, because of the great fixation areas, long fixation duration, and poor fixation results, the recovery of range of motion was limited. The outcomes were satisfied when using bone flap and periosteum transplantation technology, combined with internal fixations, such as Kirschner wire, Herbert screw, hollow screw, to treat old scaphoid fractures. With the development of biotechnology, bone materials containing bone morphogenetic protein have been applied in the clinic and achieved good therapeutic effects.
CONCLUSION: Currently, bone flap transplantation has achieved satisfactory results in treating scaphoid fractures. Application of bone morphogenetic protein / fibrin composites can enhance the therapeutic effects. The compound of autologous periosteum-wrapped tendon and spongiosa homogenate can be used as the substitute for scaphoid in future.

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