异体脱钙骨移植修复儿童期骨不连接

TREATMENT OF NONUNION IN CHIL DHOOD BY AL L OGENEIC DECAL CIFIED BONE GRAFT

目的 总结同种异体脱钙骨移植修复小儿骨不连接的效果。方法 1990年 4月～ 1997年 9月 ,用无菌操作法取同种异体的新鲜尸骨制成的脱水脱钙骨块移植修复小儿先天性骨不连接 3例 ,后天性骨不连接 14例。结果 术后随访 2～ 9年。一次手术成功 9例 ,经二次手术成功 7例 ,1例先天性胫骨假关节经二次手术 ,术后 6个月有新生骨生长 ,1年后再复发。成功的 2例先天性胫骨假关节以及 5例慢性骨髓炎骨不连接 ,随访发现肢体有1.5～ 3.0 cm的短缩 ,但关节功能正常。结论 同种异体脱钙骨修复小儿骨不连接具有骨诱导能力强 ,抗原性低 ,骨愈合快和来源丰富、使用简便等特点。

Objective To investigate the effect of allogeneic decalcified bone graft in the treatm ent of nonunion in children.Methods From April1990 to Septem ber1997,17children with nonunion were adopted in this study.Among them,there were10 boys and7girls,the age ranged from2 to13years.The allogeneic decal- cified bone grafttaken from fresh corpse by aseptic m anipulation were used to repair3cases of congenital nonunion and14cases of acquired nonunion.Results All cases were followed up2 to9years after operation,9cases were cured successfully and7cases were cured after twice operations.One case of congenital pseudoarthrosis of the tibia was operated twice and there were callus grown half years after the second operation,butreoccured after one year. Although there were1.5 cm to3cm shortening deform ity of extrem ity including another2 cases of congenital pseudoarthrosis of the tibia and5 cases of nonunion caused by chronic osteomyelitis,the function of joint was nor- mal.Conclusion Treatment of nonunion in children by allogeneic decalcified bone graft is a valuable technique in clinical practice.It is characterisied by high capacity of osteoinduction,low antigenicity,rapid bony union,plenti- ful source of bone graft and convenient utilization.