中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (8): 1133-1139.doi: 10.3969/j.issn.2095-4344.2016.08.010

• 组织工程骨及软骨材料 tissue-engineered bone and cartilage materials • 上一篇    下一篇

可吸收棒固定修复可促进青少年膝关节不稳定型剥脱性骨软骨炎的骨性愈合

程 扬1，韩长旭2   

  1. 1沈阳市骨科医院微创骨科，辽宁省沈阳市 110044；2内蒙古医科大学第二附属医院关节镜与运动医学外科，内蒙古自治区呼和浩特市 010030
  • 出版日期:2016-02-19 发布日期:2016-02-19
  • 通讯作者: 程扬，沈阳市骨科医院微创骨科，辽宁省沈阳市 110044
  • 作者简介:程扬，男，1981年生，辽宁省抚顺市人，汉族，2008年中国医科大学毕业，硕士，主治医师，主要从事微创骨科方面的研究。
  • 基金资助:
    内蒙古自治区自然科学基金(2013MS1194)

Bioabsorbable pins improve bone healing of juvenile unstable osteochondritis dissecans

Cheng Yang1, Han Chang-xu2   

  1. 1Department of Minimally Invasive Orthopedics, Shenyang Orthopaedics Hospital, Shenyang 110044, Liaoning Province, China; 2Department of Arthroscopy and Sports Medicine, Second Hospital of Inner Mongolia Medical University, Hohhot 010030, Inner Mongolia Autonomous Region, China
  • Online:2016-02-19 Published:2016-02-19
  • Contact: Cheng Yang, Department of Minimally Invasive Orthopedics, Shenyang Orthopaedics Hospital, Shenyang 110044, Liaoning Province, China
  • About author:Cheng Yang, Department of Minimally Invasive Orthopedics, Shenyang Orthopaedics Hospital, Shenyang 110044, Liaoning Province, China
  • Supported by:

    the Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2013MS1194

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被引次数

4

摘要：

文章快速阅读：

文题释义：

可吸收棒：文章中病例采用的可吸收棒成分为聚L-乳酸，固定治疗剥脱性骨软骨炎不仅能稳定骨折块，同时还能在骨折块和软骨下骨上钻孔减压，固定后3-6个月可确保骨软骨在稳固的环境下愈合。
剥脱性骨软骨炎：是指外伤后骨软骨骨折或反复轻度外伤导致血运障碍，骨软骨坏死脱落所致，或与细菌栓子或脂肪栓塞终末动脉以及家族遗传等有关。碎片包括软骨和其下方骨质，碎片与母骨之间有纤维蒂相连或无蒂游离，母骨和碎片离断面有纤维组织或纤维软骨复盖和少量新骨形成，完全游离碎片成为游离体吸收滑液营养而不断增大，游离体大小、数目不等，可发生关节绞锁，蒂断裂可导致关节内血肿，关节磨损产生关节炎。

 

背景：目前青少年膝关节不稳定型剥脱性骨软骨炎治疗方法不尽相同，效果不甚理想。
目的：试验应用可吸收棒治疗青少年膝关节不稳定型剥脱性骨软骨炎，经至少2年的随访，用Lysholm，IKDC，Hughston评分和影像学检查评估固定后临床功能恢复情况及骨折的愈合情况。
方法：膝关节不稳定型剥脱性骨软骨炎患者18例，在关节镜下确诊精确定位，小切口切开，用生物可吸收棒固定治疗。平均随访2.7年，用Lysholm，IKDC，Hughston评分评估患肢固定后功能的恢复，X射线平片观察固定后骨折的愈合情况。
结果与结论：①固定后6个月：Lysholm、IKDC评分较术前明显改善，并且一直持续到最后一次随访时，Hughston评分15例患者优，2例患者良，1例患者结果差。②X射线片显示：17例骨性愈合，愈合率达到94%，平均愈合时间为2.9个月。③结果说明，应用可吸收棒固定治疗可促进青少年不稳定型剥脱性骨软骨炎的骨性愈合。 

ORCID: 0000-0002-9466-3299 (程扬)

关键词: 生物材料, 骨生物材料, 可吸收棒, 固定, 青少年, 膝关节, 不稳定型剥脱性骨软骨炎, 膝关节镜, 临床疗效观察, 愈合率, IKDC评分, Lysholm评分, 内蒙古自治区自然科学基金

Abstract:

BACKGROUND: At present, there are different strategies for treating unsteable osteochondritis dissecans of the knee joint in adolescents, but their therapeutic effects are not ideal.
OBJECTIVE: To assess the therapeutic effect of bioabsorbable pin fixation on functional recovery and fracture healing in juvenile unstable osteochondritis dissecans through Lysholm, IKDC, Hughston scoring and imaging examination.
METHODS: Eighteen patients with unstable osteochondritis dissecans were enrolled. Under arthroscopy, a small incision was localized and cut followed by bioabsorbable pin fixation. The average follow-up period was 2.7 years. Functional recovery of the affected limbs after fixation was assessed by using Lysholm, IKDC and Hughston scoring. X-ray examination was used to observe fracture healing.
RESULTS AND CONCLUSION: At 6 months after fixation, the Lysholm and IKDC scores were improved significantly as compared with those before operation and maintained till the last following up. There were 15 patients scored as excellent, 2 as good and 1 as poor. X-ray films also showed that there were 17 cases of fracture healing (94% healing rate). The average fracture healing time was 2.9 months. These findings indicate that the bioabsorbable pins can improve the bone healing in juvenile unstable osteochondritis dissecans.