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髂骨供骨后骨缺损的重建及供区并发症的预防
Hits: 1563   Download times: 1189   Received:February 25, 2007    
作者Author单位UnitE-Mail
牛云飞 NIU Yun-fei 第二军医大学长海医院骨科,上海200433 Department of Orthopaedics,Changhai Hospital,the Second Military Medical University,Shanghai 200433,China  
张春才 ZHANG Chun-cai 第二军医大学长海医院骨科,上海200433 Department of Orthopaedics,Changhai Hospital,the Second Military Medical University,Shanghai 200433,China  
王家林 WANG Jia-lin 第二军医大学长海医院骨科,上海200433 Department of Orthopaedics,Changhai Hospital,the Second Military Medical University,Shanghai 200433,China  
许硕贵 XU Shuo-gui 第二军医大学长海医院骨科,上海200433 Department of Orthopaedics,Changhai Hospital,the Second Military Medical University,Shanghai 200433,China  
苏佳灿 SU Jia-can 第二军医大学长海医院骨科,上海200433 Department of Orthopaedics,Changhai Hospital,the Second Military Medical University,Shanghai 200433,China  
张鹏 ZHANG Peng 第二军医大学长海医院骨科,上海200433 Department of Orthopaedics,Changhai Hospital,the Second Military Medical University,Shanghai 200433,China  
期刊信息:《中国骨伤》2007年20卷,第5期,第313-315页
DOI:doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz


目的:探讨通过同种异体髂骨重建自体髂骨供骨后骨缺损预防供区并发症的治疗方法及效果。

方法:采用同种异体髂骨修补自体髂骨供骨后骨缺损20例,男9例,女11例;年龄19~56岁,平均34岁;共用22块髂骨;同种异体髂骨块为全厚或半厚,大小6cm×5cm、5cm×4cm、4cm×3cm3种规格;其中19块采用空心钉固定,2块采用空心钉结合克氏针固定,1块单独采用克氏针固定。

结果:20例患者均获随访,随访时间8~20个月,平均13.5个月。19例切口Ⅰ期愈合,1例发生皮肤浅表感染,经换药Ⅱ期愈合。所有患者手术后供骨区髂部外形保持完整,未发生植骨块移位、植入物松动、断裂、免疫排斥反应等并发症。术后6个月复查未发现供骨区慢性疼痛、系腰带痛及行走痛。所有患者对髂部外形表示满意。

结论:同种异体髂骨可有效重建自体髂骨供骨后骨缺损,预防髂骨供区并发症。
[关键词]:同种异体移植  髂骨  骨折,不愈合  骨折固定术,内
 
Reconstruction of massive iliac defect and prevention of donor site complication
Abstract:

Objective:To explore the method and clinical effect of reconstructing massive iliac defect with allogenic iliac grafts after autograft.

Methods:Twenty patients were treated by allograft for massive iliac defect,including nine male and eleven female with an average age of 34(range 19 to 56)years.Twenty-two block of omni-thick or semi-thick allogenic iliac bone were implanted and the sizes of allograft were 6 cm×5 cm,5 cm×4 cm,4 cm×3 cm.Nineteen block of allograft were fixed with cannulated nails,2 were fixed with cannulated nails and Kirschner wire and 1 with Kirschner wire only.

Results:Twenty patients were followed up for an average of 13.5(range 8 to 20)months.The incision of 19 patients primarily healed.One patient suffered superficial infection and wound healed after a regular dressing change for three weeks.Perfect appearance of pars iliaca not changed perioperatively and all patients were satisfied.No implant displacement,loosening or breakage had happened and immunological rejection didn′t appear in all the patients.No patients complained chronic pain,tenderness or walking pain 6 months after operation.

Conclusion:Allogenic iliac bone is an available substitute to reconstructing the integrity of ilium and preventing complication of donor site.
KEYWORDS:Allograft  Iliac bone  Fractures,ununited  Fracture fixation,internal
 
引用本文,请按以下格式著录参考文献:
中文格式:牛云飞,张春才,王家林,许硕贵,苏佳灿,张鹏.髂骨供骨后骨缺损的重建及供区并发症的预防[J].中国骨伤,2007,20(5):313~315
英文格式:NIU Yun-fei,ZHANG Chun-cai,WANG Jia-lin,XU Shuo-gui,SU Jia-can,ZHANG Peng.Reconstruction of massive iliac defect and prevention of donor site complication[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(5):313~315
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