应用Masquelet技术修复骨缺损的研究进展

PROGRESS OF Masquelet TECHNIQUE TO REPAIR BONE DEFECT

目的综述应用Masquelet技术修复骨缺损的研究进展。 方法广泛查阅近年来有关应用Masquelet技术修复骨缺损的文献，对其进行综合分析。 结果Masquelet技术包括两个阶段手术，第一阶段：先彻底清创，以骨水泥填充骨缺损区，待骨水泥周围诱导形成诱导膜结构；第二阶段：6～8周后取出骨水泥，在诱导膜内植入较丰富松质骨，通过诱导膜内松质骨较快成骨并皮质化来修复长段皮质骨缺损。实验研究显示，诱导膜上有小血管系统，还富含VEGF、TGF-β1、BMP-2和骨祖细胞等，具有诱导成骨属性；在几乎各部位、各种类型骨缺损临床应用中，包括缺损长达25 cm患者，均取得满意修复效果。与现有其他方法相比，Masquelet技术具有疗效可靠、操作简便、并发症少、对受区要求低、易推广等优点。 结论Masquelet技术是修复骨缺损的有效方法之一，适应于各种类型骨缺损，尤其适合感染性和肿瘤性骨缺损。

ObjectiveTo summarize the progress of Masquelet technique to repair bone defect. MethodsThe recent literature concerning the application of Masquelet technique to repair bone defect was extensively reviewed and summarized. ResultsMasquelet technique involves a two-step procedure. First, bone cement is used to fill the bone defect after a thorough debridement, and an induced membrane structure surrounding the spacer formed; then the bone cement is removed after 6-8 weeks, and rich cancellous bone is implanted into the induced membrane. Massive cortical bone defect is repaired by new bone forming and consolidation. Experiments show that the induced membrane has vascular system and is also rich in vascular endothelial growth factor, transforming growth factor β1, bone morphogenetic protein 2, and bone progenitor cells, so it has osteoinductive property; satisfactory results have been achieved in clinical application of almost all parts of defects, various types of bone defect and massive defect up to 25 cm long. Compared with other repair methods, Masquelet technique has the advantages of reliable effect, easy to operate, few complications, low requirements for recipient site, and wide application. ConclusionMasquelet technique is an effective method to repair bone defect and is suitable for various types of bone defect, especially for bone defects caused by infection and tumor resection.