CAJ | 학술논문

目的探讨应用可吸收螺钉(grand fix)内固定结合bFGF生物蛋白海绵(创必复)治疗陈旧性舟骨骨折及骨不连的临床疗效及安全性.方法对9例陈旧性舟骨骨折按Herbert分型:Ⅲ型6例,Ⅳa型2例,Ⅳb型1例.取桡背侧切口,应用可吸收螺钉内固定,骨折端填塞、覆盖bFGF生物蛋白海绵.结果 9例术后随访时间平均为7.3个月.其中8例舟骨骨折全部愈合,腕关节活动范围:掌屈45.～55.,背伸40°～50°,桡偏20°～25°,尺偏25°～35°;腕部握力平均恢复至健侧的88％.1例舟骨不愈合,骨折端硬化,持重物后疼痛、无力,腕关节活动范围:掌屈20°,背伸25°,桡偏10°,尺偏15°.术后全部患腕均无过敏反应及感染发生.结论可吸收螺钌内固定结合bFGF生物蛋白海绵治疗陈旧性舟骨骨折,具有生物相容性好、固定可靠、安全性高等优点,可促进舟骨骨折愈合.
목적 탐토응용가흡수라정(grand fix)내고정결합bFGF생물단백해면(창필복)치료진구성주골골절급골불련적림상료효급안전성.방법 대9례진구성주골골절안Herbert분형:Ⅲ형6례,Ⅳa형2례,Ⅳb형1례.취뇨배측절구,응용가흡수라정내고정,골절단전새、복개bFGF생물단백해면.결과 9례술후수방시간평균위7.3개월.기중8례주골골절전부유합,완관절활동범위:장굴45.～55.,배신40°～50°,뇨편20°～25°,척편25°～35°;완부악력평균회복지건측적88％.1례주골불유합,골절단경화,지중물후동통、무력,완관절활동범위:장굴20°,배신25°,뇨편10°,척편15°.술후전부환완균무과민반응급감염발생.결론 가흡수라조내고정결합bFGF생물단백해면치료진구성주골골절,구유생물상용성호、고정가고、안전성고등우점,가촉진주골골절유합.
Objective To investigate the clinical efficacy and safety of absorbable screw(GRAND FIX)fixation combined with basic fibroblast growth factor (bFGF) sponge on old scaphoid fractures and nonunion.Methods Nine cases of old scaphoid fractures were collected,including six cases of type Ⅲ,two cases of Ⅳ a,and one case of Ⅳ b according to Herbert classification.Absorbable screws were implanted for internal fixation,and fracture ends were filled and covered with bFGF sponge through a radial-dorsal incision. Results All of the nine cases received a mean follow-up of7.3 months.Eight cases had union,and ranges of wrist motion were as follows:flexion 45° to 55°,extension 40° to 50°,radial deviation 20° to 25°,and ulnar deviation 25° to 35°.The grip strength was 88％ of the contralateral side.Only one case had nonunion in which the fracture ends became sclerotic,and felt pain and weakness after holding weights.Range of wrist motion in this patient was as follows:flexion 20°,extension 25°,radial deviation 10° and ulnar deviation 15°.No allergic reactions and infection occurred. Conclusion Absorbable screw fixation combined with bFGF sponge to treat old scaphoid fractures has the advantage of good biocompatibility,reliable fixation and safety.bFGF can promote healing of scaphoid fractures.