CAJ | 학술논문

目的：观察关节镜下可注射组织工程骨治疗关节周围骨折骨不连的疗效。方法选取关节内骨折骨不连患者6例,其中肱骨髁间骨折3例,股骨髁部骨折2例,胫骨平台骨折1例。关节镜下行骨不连部位清理术,直视下用穿刺针将组织工程骨注射于骨折端,必要时经皮穿针内固定。对患者进行定期随访,X线检查观察骨不连愈合状态,观察骨愈合情况及并发症,复查时间分别为术后3个月、6个月、9个月、12个月。结果术后随访9~12个月；所有患者各部位骨折均愈合；骨痂愈合时间为(8.34±2.4)周；骨折愈合时间为(18.2±3.3)周。术后均以Johner-Wruhs功能分级法评定患者功能恢复情况,其中5例为优,1例为良。1例(胫骨平台)术后出现炎性反应,经万古霉素抗炎治疗2周后症状消失；1例(股骨髁间骨折)出现下肢深静脉血栓,经系统抗凝治疗后症状消失。结论关节镜下可注射组织工程骨治疗关节周围骨折骨不连安全、有效。
목적：관찰관절경하가주사조직공정골치료관절주위골절골불련적료효。방법선취관절내골절골불련환자6례,기중굉골과간골절3례,고골과부골절2례,경골평태골절1례。관절경하행골불련부위청리술,직시하용천자침장조직공정골주사우골절단,필요시경피천침내고정。대환자진행정기수방,X선검사관찰골불련유합상태,관찰골유합정황급병발증,복사시간분별위술후3개월、6개월、9개월、12개월。결과술후수방9~12개월；소유환자각부위골절균유합；골가유합시간위(8.34±2.4)주；골절유합시간위(18.2±3.3)주。술후균이Johner-Wruhs공능분급법평정환자공능회복정황,기중5례위우,1례위량。1례(경골평태)술후출현염성반응,경만고매소항염치료2주후증상소실；1례(고골과간골절)출현하지심정맥혈전,경계통항응치료후증상소실。결론관절경하가주사조직공정골치료관절주위골절골불련안전、유효。
Objective To observe the effect of injectable tissue-engineered bone in treating periarticular bone fracture nonunion under arthroscopy. Methods Selected 6 patients with intra-articular bone fracture nonunion:3 cases of humerus intercondylar fracture;2 cases of femoral condylar fracture and 1 cases of tibial plateau fracture. All of the 6 patients have undergone arthroscopic debridment and tissue-engi-neered bone injection in the the fracture ends with puncture needle under direct vision. Percutaneous needle internal fixation were performed if necessary. All the patients have got regular follow-up after the operation process. Check their healing condition with X-ray examination, and the healing of the bone and its complications have also been monitored. Reexamination were made 3, 6, 9, and 12 months after surgery. Results All the patients have experienced successful operation and all the fracture have healed up. The X-ray review showed that the callus healing time was (8. 34 ± 2. 4) weeks and fracture healing time was (18. 2 ± 3. 3) weeks. Accordong to Johner-Wruhs functional category, there were 5 cases of excellent recovery and 1 case of medium recovery. Among these patients, inflammatory reaction occurred in 1 case, and the symptoms disappeared after 2 weeks of Vancomycin anti-inflammatory treatment; deep venous thrombosis occurred in 1 case, and the symptoms disappeared after systematic anticoagulant therapy. Conclusion It’ s safe and effective to treat periarticular bone fracture nonunion with injectable tissue-engineered bone under arthroscopy.