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经皮撬拨复位加自固化磷酸钙人工骨植入治疗跟骨骨折

目的 总结经皮撬拨复位结合自固化磷酸钙人工骨植入治疗跟骨骨折的治疗方法和效果。 方 法 2004 年6 月－ 2008 年6 月，收治跟骨骨折13 例。男11 例，女2 例；年龄18 ～ 61 岁，平均38 岁。高处坠落伤9 例，砸伤4 例。均为单侧闭合骨折。按Sanders 分型：Ⅱ型5 例，Ⅲ型7 例，Ⅳ型1 例。X线片示Bouml;hler 角为— 10 ～ 15°，平均5°。受伤至手术时间4 h ～ 2 d。行经皮克氏针撬拨复位骨折，于骨折缺损处注入4 ～ 6 mL 注射型自固化磷酸钙人工骨修复。 结果 术后无软组织坏死及感染发生。13 例均获随访，随访时间1 ～ 2 年。X 线片示骨折均于术后3 ～ 5 个月愈合；Bouml;hler 角为15 ～ 40°，平均27.8°。关节面复位高度无丢失，骨折愈合后逐渐恢复负重行走功能。注射型材料未引起血磷、血钙增高及过敏、毒性反应。11 例于术后6 个月自固化磷酸钙人工骨完全降解，2 例于8 个月降解完全；降解同时骨组织生成。按美国足踝外科学会（AOFAS）评分：优7 例，良4 例，一般2 例，优良率84.6%。 结论 经皮撬拨复位加自固化磷酸钙人工骨植入治疗跟骨骨折具有操作简便、创伤小、并发症少的优点。

PRELIMINARY CLINICAL APPLICATION OF CANCELLOUS GRANULE-TYPE CALCIUM PHOSPHATE CEMENT

Objective To investigate the cl inical efficacy of the cancellous granule-type calcium phosphate cement in repair bone defect. Methods Between July 2008 and July 2009, 35 patients (42 l imbs) with fractures, nonunion, and benign bone tumor were treated with cancellous granule-type calcium phosphate cement. There were 32 males and 3 females,with an age range from 9 to 73 years (median, 41 years), including 24 l imb fractures (19 cases), 4 osteotomy for deformity of ulna and radius (2 cases), 2 femur intertrochanteric bony cysts (2 cases), 3 enchondroma (3 cases), 5 bone defect at donor il ium (5 cases), 3 nonunion (3 cases), and 1 lumbar spinal stenosis (1 case). The size of bone defect was 1-5 cm. Bone defect was repaired with cancellous granule-type calcium phosphate cement (1-5 g). Results All cases were followed up 8-23 months (13.7 months on average). Thirty-nine incisions (32 cases) healed by first intention and the suture was removed after 10-14 days. Incision dehiscence occurred in 2 cases, and wounds healed after second debridement and removal of artificial bone. Exudation of incision occurred in 1 case, and wound healed after symptomatic treatment. No local red swell ing, higher temperature, maculopapule, and ulceration of skin occurred at implantation site. X-ray films showed that bone graft fusion was achieved and bone defect was radically repaired at 6 months after operation and artificial bone was absorbed completely at 12 months. Conclusion Cancellous granule-type calcium phosphate cement can be used as a new graft bone material, which is suitable for defect fill ing after traumatic fracture, benign bone tumors, and il iac bone donor.

自固化磷酸钙人工骨在跟骨骨折治疗中的应用

自固化磷酸钙人工骨在腰椎结核病灶清除术中的初步应用

REPAIR OF BONE DEFECT DUE TO TUMOUR RESECTION WITH SELF-SETTING CALCIUM PHOSPHATE CEMENT IN CHILDREN

OBJECTIVE: To study the effect of self-setting calcium phosphate cement (CPC) on the repair of local bone defects after resection of cyst in children. METHODS: From December 1998 to May 2002, 22 patients with bone defects were repaired with CPC. Their ages ranged from 4 to 10 years with an average of 8.3 years. There were 11 cases of non-ossifying fibroma, 7 cases of osteoid osteoma, 2 cases of bone cyst and 2 cases of fibrous dysplasia. The bone defects are located as the following: femur in 14 cases, tibia in 6 cases and humerus in 2 cases. CPC spongiosa granules were filled in 11 cases, injectable CPC were filled in 2 bone cyst cases. The patients were followed up for 5-48 months, averaged 23.5 months. RESULTS: Bone matrix grew well and no recurrence was found. CONCLUSION: The method with simple CPC in repairing bone defects is safe, non-toxic, economic and convenient in children.