目的:回顧性研究人工肱骨頭置換治療復雜肱骨近端骨折患者的肩關節的情況,以進一步提高療效。方法:對我院2004年至2007年27例肱骨近端骨折患者采用肱骨頭置換術治療,術中修復關節囊和肩袖,術后隨訪5~38月,評價其肩關節功能。結果:采用半關節成形改良評分系統SSMH綜合評分,優:5例,良:17例,可:5例,優良率:815%。肩關節活動:平均前屈上舉:96°,外旋:36°,內旋至L2水平。X片示假體無松動斷裂,位置良好。結論:對于復雜的肱骨近端骨折,人工肱骨頭置換是有效治療手段,能夠最大限度恢復期肩關節活動功能。
To summarize the medium-term cl inical result of bio-derived bone transplantation in orthopedics with tissue engineering technique. Methods From December 2000 to June 2001, 10 cases of various types of bone defect were treated with tissue engineered bone, which was constructed in vitro by allogenous osteoblasts from periosteum (1 × 106/ mL) with bio-derived bone scaffold following 3 to 7 days co-culture. Six men and 4 women were involved in this study, aged from 14 to 70 years with a median of 42 years. Among them, there were 2 cases of bone cyst, 1 case of non-union of old fracture, 6 cases of fresh comminuted fracture with bone defect, and 1 case of chronic suppurative ostemyel itis. The total weight of tissue engineered bone was 3-15 g in all the cases, averaged 7.3 g in each case. Results The wound in all the case healed by first intention. For 7 year follow up, bone union was completed within 3.0 to 4.5 months in 9 cases, but loosening occurred and the graft was taken out 1 year after operation in 1 case. The X-ray films showed that 9 cases achieved union except one who received resection of the head of humerus. No obvious abnormities were observed, and the function of affected l imbs met daily l ife and work. Conclusion Bio-derived tissue engineered bone has good osteogenesis. No obvious rejection and other compl ications are observed in the cl inical appl ication.