Absorbable artificial bone for repair of comminuted calcaneal fractures

doi:10.3969/j.issn.2095-4344.2014.39.025

Abstract

Abstract:

BACKGROUND: Currently, surgical treatment for Sanders III type, IV type fractures to restore damaged subtalar surface of the calcaneus and calcaneal shape, in order to reduce the incidence of traumatic arthritis has reached a consensus, and whether bone grafting is selected during surgery for calcaneal fractures has been a controversial issue.

OBJECTIVE: To observe the clinical effect of Genex synthetic bone transplants and locking plate on comminuted calcaneal fractures.

METHODS: Twenty-one cases of Sanders III type, IV type calcaneal fractures were retrospectively analyzed, including 16 males and 5 females, aged 22 to 55 years. After fracture reduction, a dough-like Genex bone graft was implanted into the defect region via lateral “L” shaped approach, and then the lateral wall of the bone was reset followed by internal fixation with the pre-curved locking plate. Follow-up observation was performed for fracture healing, Bolher angle and the Maryland Foot Score.

RESULTS AND CONCLUSION: Totally 21 patients were followed up for 8-16 months. The fractures were healed without displacement, collapse and rejection. The bone graft was degraded within 6 months and completed absorbed after 1 year. According to Maryland Foot Score, the excellent rate was up to 86%, and the Bolher angle was increased from an average preoperative (5.3±3.35)° to postoperative (24.3±1.06)°. Genex artificial bone meal is a biomaterial that can be completely absorbed, has good plasticity and strong supporting force, and it is able to fully fill bone defects, be easy to fracture reduction, induce bone formation, and promote fracture healing.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: calcaneus, fractures, bone, bone transplantation

CLC Number:

R318

Sun Hui, Zang Xue-hui, Gao Li-hua, Tan Yong-tao. Absorbable artificial bone for repair of comminuted calcaneal fractures[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(39): 6375-6380.

Figures/Tables 1

References

[1]赵磊,王黎明,王钢锐,等.经皮微创空心螺钉内固定治疗跟骨骨折[J].临床骨科杂志,2009,12(3):298-299.
[2]Bucholz RW,Hechman JD,Court-Brown C. Rockwood and Green’s fractures in Adults. Philadelphia,USA: Lippincott Williams ＆Wilkins / Wolters Kluwer Health Inc, 2006:1877- 1885.
[3]赵宏谋,杨云峰,俞光.植骨与不植骨切开复位内固定治疗跟骨关节内骨折的比较研究[J].中华创伤骨科杂志,2011,13(8): 725-729.
[4]Jones CB,Mayo KA.Nonunion Treatment: iliac crest bone graft techniques.J Orthop Trauma. 2005;19(10 Suppl): S11-13.
[5]刘鹏,赵建华,范伟力,等.骨移替代物医用硫酸钙初步临床应用[J].中国修复重建外科杂志,2006,20(11):1066-1069.
[6]Sanders R,Fortin P,Di Pasquale T,et al.Operative treatment in 120 displaced intraarticular calcaneal fractures.Results using a prognostic computed tomography scan classification.Clin Orthop Relat Res.1993;(290):87-95.
[7]占蓓蕾,叶舟.Genex椎体成形在胸腰椎爆裂性骨折治疗中的意义[J].中国骨伤杂志,2011,24(3):223-226.
[8]唐纳德A.威斯.骨折[M].李正维译.沈阳:辽宁科学技术出版社, 2005:585-602.
[9]蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2007:241-243.
[10]高士濂.实用解剖图谱:下肢分册[M].上海:上海科学技术出版社, 1985:303.
[11]Simon RR.急诊骨科学[M].肖德明主译.北京:人民卫生出版社, 2004:214-218.
[12]高成堂,张春才,张庆宏.跟骨关节内骨折内固定手术并发症分析[J].中华骨科杂志,2005,25(1):41-44.
[13]Sanders R.Displaced intra-articular fractures of the calcaneus.J Bone Joint Surg Am.2000;82(2):225-250.
[14]Leung KS,Yuen KM,Chan WS.Operative treatm ent of displaced intra-articular fractures of the calcaneum. Medium- term results.J Bone Joint Surg Br.1993;75(2):196-201.
[15]Chan S,Ip FK.Open reduction and internal fixation for displaced intra-articular fractures of the OS calcis. Injury. 1995; 26(2):1l1-115.
[16]李文壮,蔡湘波,白卫东.AO跟骨7钢板治疗Sander IV型跟骨骨折[J].中华创伤骨科杂志,2004,6(11):41-45.
[17]赵宏谋,杨云峰,俞光.植骨与不植骨切开复位内固定治疗跟骨关节内骨折的比较研究[J].中华创伤骨科杂志,2011,13(8): 725-729.
[18]赖爱宁,王朝阳,梁再跃,等.髂骨块在跟骨严重骨折手术中的应用[J].中国矫形外科杂志,2008,16(10):784-786.
[19]周磊,闫景龙,胡春杰.聚磷酸钙纤维/磷酸钙骨水泥/微小颗粒骨修复骨缺损的实验研究[J].中国骨与关节损伤杂志,2007,22(12): 1002-1005.
[20]Pache G,Krauss B,Strohm P,et al.Dual-energy CT virtual noncalcium technique: detecting posttraumatic bone marrow lesions--feasibility study.Radiology.2010; 256(2):617-624.
[21]Laurencin C,Khan Y,El-Amin SF.Bone graft substitutes.Expert Rev Med Devices.2006; 3(1):49-57.
[22]Leone Jr WA,Naughton M,Gratto-Cox G,et al.The effect of preoperative planning and impaction grafting surgical technique on intraoperative and postoperative complication rate for femoral revision patients with moderate to severe bone loss:mean 4.7-year results.J Arthroplasty. 2008;23: 383-394.
[23]Belkof SM,Molloy S.Temperature measurement during polymerization of polymethylmethaerylate cement used for vertebroplasty. Spine(Phila Pa 1976).2003;28:1555-1559.
[24]Deramond H,Wright NT,Belkof SM.Temperature elevation caused by bone cement polymerization during vertebroplasty. Bone.1999;25:17S-21S.
[25]Espanol M,Perez RA,Montufar EB,et al.Intrinsic porosity of calcium phosphate cements and its significance for drug delivery and tissue engineering applications.Actca Biomater. 2009;5(7):2752-2762.
[26]Nezafati N,Moztarzadeh F,Hesaraki S,et al.Synergistically reinforcement of a self-setting calcium phosphate cement with bioactive glass fibers.Ceram Int.2011;37(3):927-934.
[27]姜星杰,吴小涛,张绍东,等.硫酸钙骨水泥降解成骨性能的实验研究[J].中华创伤骨科杂志,2007,9(8):717-720.
[28]Ryu KS,Shim JH,Heo HY,et al.Therapeutic eficacy of injectable calcium phosphate cement in osteoporotic vertebral compression fractures: prospective nonrandomized controlled study at 6-month follow -up.World Neurosurg. 2010;73: 408-411.
[29]Piazzolla A,De Giorgi G,Solarino G.Vertebral body recollapse without trauma after kyphoplasty with calcium phosphate cement.Musculoskelet Surg.2011;95:141-145.
[30]Gioia G,Mandelli D,Gogue R.Treatment of typical amyelic somatic fractures with kyphoplasty and calcium phosphate cement：a critical analysis.Eur Spine J.2012;21 Suppl 1: S108-S111.
[31]占蓓蕾,叶舟.Genex椎体成形在胸腰椎爆裂性骨折治疗中的意义[J].中国骨伤杂志,2011,24(3):223-226.
[32]杨惠光,张云庆,刘勇,等.Genex骨水泥结合短节段椎弓根内固定治疗骨质疏松性骨折伴真空征[J].实用骨科杂志,2012,18(7): 583-586.
[33]陈雁西,梅炯,刘新成,等.跟骨锁定钢板治疗跟骨关节内粉碎性骨折的疗效分析[J].中华创伤骨科杂志,2008,10(12):1121-1125.