重组合异种骨治疗股骨非感染性骨不连的长期疗效观察

目的:探讨重组合异种骨治疗股骨非感染性骨不连的长期临床疗效。方法:对2000年1月至2006年9月间我院应用重组合异种骨(RBX)治疗的37例股骨非感染性骨不连患者进行回顾性分析,其中男26例,女11例;年龄4～70岁,平均31.6岁。骨折部位:股骨近端4例,中段30例,远端3例。骨不连类型:肥大型9例,营养不良型6例,萎缩型22例。固定方式:加压钢板24例,髓内钉11例,外固定架2例。结果:37例患者获得51-131个月的随访,平均90.2个月,骨不连一次手术愈合率:94.6%,4例股骨近端骨不连患者采用Harris评分系统评定疗效,优3例,良1例,差0例,优良率100%。3例股骨远端骨不连患者采用美国膝关节协会评分系统(KSS)评定疗效,优1例,例良1例,差1例,优良率66.7%。30例股骨干骨不连患者采用Harris评分系统和KSS评定疗效,优21例,良8例,差1例,优良率96.7。总优良率94.6%。长期观察均无免疫排斥反应表现。结论:RBX用于治疗股骨非感染性骨不连具有材料充足、骨折愈合率高、组织兼容性好长期应用无免疫排斥反应等优点,是一种良好的自体骨替代材料。

Long-Term Efficacy Observation of Recombinant Bone Xenograft in Treatment of Femoral Non-Infected Nonunion

Objective: To evaluate long-term efficacy of recombinant bone xenograft in treatment of femoral non-infected nonunion.Methods: 37 patients suffered with femoral non-infected nonunion since 2000 was analyzed retrospectively,which included 26 males and 11 females,with the mean age of 31.6 years(ranged from 4 to 70 years).The nonunion site: the proximal femur in 4 cases,the middle 30 cases,3 cases of distal.There were 9 hypertrophic,6 malnourished,22 atrophic.24 cases with plate,11 cases with intramedullary nailing and 2 cases with external fixation.Results: The average follow-up time of these cases was 90.2 months,from 51 months to 131 months.94.6% of these patients healed with only one operation.By the Harris scale,of the 4case of proximal femoral nonunion,the hip functions were rate as excellent in 3,good in 4 and no fair,with an excellent to good rate of 100%.By the American Knee Society Score(KSS),of the 3cases of distal femoral nonunion,the knee function was rated as excellent in 1,good in 1 and fair in 1,with an excellent to good rate of 66.7%.By the sanders Kss systems,of the 30 cases of femoral shaft nonunion,the hip and knee functions were rated as excellent in 21,good in 8 and fair in 1,with an excellent to good rate of 96.7%.The total excellent to good rate was 94.6%.No one has immune rejection in this long-term observation.Conclusion: RBX for the treatment of femoral non-infected nonunion has many advantages,such as sufficient materia,high rate of fracture healing,a nice biological compatibility,it can be used in the clinic instead of autologous bone.