高强度可注射型硫酸钙植骨材料治疗胫骨平台骨折21例

Treatment of tibial plateau fractures with high-strength injectable calcium sulfate: An analysis of 21 cases

解放军第二军医大学附属长海医院2005-10/2007-10治疗21例胫骨平台骨折患者,其中SchatzkerⅡ型12例,SchatzkerⅢ型5例,SchatzkerⅣ型2例,SchatzkerⅤ型1例,SchatzkerⅥ型1例。17例使用MIIGTMX3型高强度可注射硫酸钙,4例使用MIIGTMX3HiVisc型高强度可注射硫酸钙。20例患者获得随访,平均22.1个月。所有患者均获得骨性愈合,无骨不连发生;无感染情况发生;2例患者切口有渗出,渗出液细菌培养为阴性。术后4周高强度可注射硫酸钙开始明显吸收,术后12周基本吸收,术后6个月高强度可注射硫酸钙植入区域与正常松质骨一致。20例术后半年Rasmussen膝关节功能平均25.8分,12例术后1年Rasmussen膝关节功能平均26.9分。术后1年1例发生胫骨平台高度丢失约2mm,但无关节功能障碍。结果提示应用MIIGTMX3或MIIGTMX3HiVisc可注射式人工植骨材料治疗胫骨平台骨折,能有效避免骨折再移位和关节面高度的丢失,与宿主无生物相容性不良反应,并具有提高关节早期功能锻炼安全性的特点。

Twenty-first patients with tibial plateau fractures, including Schatzker Ⅱ （n=12）, SchatzkerⅢ （n=5）, Schatzker Ⅳ （n=2）, Schatzker Ⅴ, and Schatzker Ⅵ[（n=1）, were collected from Changhai Hospital Affiliated to the Second Military Medical University of Chinese PLA from October 2005 to October 2007. High-strength injectable calcium sulfate （MIIGTMX3） was treated on 17 cases, and MIIGTMX3HNsc was on 4 cases. Twenty patients underwent following up, mean period of 22.1 months. Bone union was found in all the patients, but nonunion or infection was not found. Wound exudations were observed in two cases and the bacterial culture was negative. MIIGTMX3 was absorbed 4 weeks postoperatively and generally completely absorbed 12 weeks postoperatively. Injecting region of MIIGTMX3 was coincidence with normal cancellated bone 6 months postoperatively. The Rasmussen score was 25.8 of 20 patients after 6 months and 26.9 of 12 patients after 12 months. Two millimeter height loss of tibial plateau was found in one patient one year after operation without knee function impairment. The use of MIIGTMX3 or MIIGTMX3HVsc in treating tibial plateau fractures could effectively prevent the fractures re-displacement and reduction loss, and improve the safety of early stage motion in functional rehabilitation. In addition, both of them did not have adverse effect on host.