同种异体骨移植治疗胫骨平台骨折22例

Bone allograft for tibial plateau fractures in 22 cases

1998-02/2004-04吉林大学第一医院骨科采用骨折切开复位钢板内固定,同时应用深低温冷冻和γ射线照射处理的同种异体松质骨移植治疗胫骨平台骨折22例。所有患者移植后12～24个月,根据Rasmussen膝关节功能评分和移植后X射线摄片评价其修复效果。移植后随访Rasmussen膝关节功能评分优12例,良6例,可2例,差2例,优良率88.9%。仅1例患者出现感染,移植骨与宿主骨没有融合,其余患者未出现免疫排斥反应和感染,无骨质再吸收,未出现明显骨质疏松及移植骨周围硬化现象。提示经过深低温冷冻和γ射线照射处理保存的同种异体骨移植降低了免疫源性,避免了自体骨移植的弊端,可以作为胫骨平台骨折植骨的理想方法之一。

Twenty-two patients with tibial plateau fracture were treated with open reduction and plate fixation plus cancellous bone allogaft （fresh-frozen and gamma-irradiated） in Department of Orthopedics, First Hospital of Jilin University between January 1998 and April 2004. The clinical effects were assessed by Rasmussen score and X-ray after 12-24 months postoperatively. After operation the average excellent and good Rasmussen score was 88.9% including 12 cases of excellent, 6 of good, 2 of fair and 2 of poor. Only one patient developed infection and nonunion. No rejection, infection, resorption, osteoporosis or scelorosis was founded in other patients. The frozen and gamma-irradiated bone allograft decreased bone immunogenicity, and is a good alternative in the treatment of plateau fractures to avoid donor site morbidity.