钛网打压植骨重建四肢长骨节段骨缺损

Impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone

背景:四肢长骨节段骨缺损临床上常见,一直以来是骨科修复领域的难题。目的:介绍钛网打压植骨重建四肢长骨节段骨缺损新方法的实验研究和临床用用。方法:第一作者应用计算机检索1990至2011年PubMed数据库(http://www.ncbi.nlm.nih.gov/PubMed),CNKI数据库(www.cnki.net/index.htm),和维普数据库(http//www.cqvip.com)有关钛网打压植骨重建四肢长骨节段骨缺方面的文献,英文检索词为"segmental bone defect,titanium mesh or titanium cage";中文检索词为"四肢或长骨,骨缺损,钛网"。排除重复性研究、非四肢长骨和Meta分析类文献。根据纳入标准,共检索到30篇文献进行归纳总结。结果与结论:钛网打压植骨重建四肢长骨节段骨缺损无论在大动物或是小动物的实验中均取得较好的成骨效果,优于非钛网的游离植骨和大块皮质骨游离植骨;自体骨、异体骨和人工骨均是可行的填充植骨材料,以自体松质骨为主的植骨材料的成骨效果相对较好,具有生物活性钛网较普通钛网的成骨效果更好。临床上,在四肢长骨各个部位的节段骨缺损中均取得很好的治疗效果,包括骨缺损长达十余厘米的病例。钛网打压植骨重建四肢长骨节段骨缺损新方法,改变了以往认为大于6cm以上长段骨缺损只适宜带血运的骨移植、而不适宜无血运游离植骨的传统观点。该方法较简单、安全、有效,是一种较理想的替代治疗长骨骨干部节段骨缺损的无血运游离植骨法。

BACKGROUND：Segmental defect of limb long bone is common in clinic,which has long been a problem in the field of reconstruction and repair of bone.OBJECTIVE：To introduce a new method of impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone,including its experimental research and clinical applications.METHODS：The PubMed database（http：//www.ncbi.nlm.nih.gov/PubMed）,CNKI database（www.cnki.net/index.htm）,VIP database（http//www.cqvip.com/） between 1990 and 2011 were searched by the first author for the articles relate to impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone.The English key words were ＂segmental bone defect,titanium mesh or titanium cage＂ and the Chinese key words were ＂limbs or lone bone,segmental bone defect,titanium mesh or titanium cage＂.The repetitive studies,non-limb long bone and Meta-analysis articles were excluded.According to the inclusion and exclusion criteria,a total of 30 literatures were included to review. RESULTS AND CONCLUSION：Impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone have achieved good results for bone formation in both large and small animal experiments,which was superior to free bone graft without titanium mesh and free large cortical bone graft.Autologous bone,allograft bone and artificial bone are feasible materials for bone graft,but autogenous cancellous bone is relatively better and bioactive titanium mesh of the autogenous cancellous bone is better than general titanium mesh.Clinically,it has achieved good therapeutic effect in all parts of long bone segmental bone defects,including long bone defect cases that more than 10 cm.The impacted bone graft in a titanium mesh for reconstructing segmental defect of limb long bone is a new method,which changed the old view of more than 6 cm long bone defect is only suitable for vascularized bone graft,not suitable for non-vascularized free bone graft.It is relatively simple,safe and effective,and it is an ideal non-vascularized free bone graft for the treatment of segmental long bone defects.