固骼生(Osteoglas^(TM))替代骨移植修复四肢骨缺损的临床应用

The Clinical Application on OsteoglasTM Substitute Bone graft，Repair Bone Defects of Extremities．

目的 通过对固骼生（Osteoglas）修复四肢骨折骨不连及骨缺损临床观察，探讨生物活性材料在骨科中替代骨移植作用机理，从而为生物活性玻璃中骨科中的应用提供理论依据。 方法 对24例骨缺损，18例骨不连、骨连断端咬除瘢痕组织及硬化骨，并钻孔到髓腔后，将生物活性玻璃颗粒充填，或与内固定，外固定结合，术后第4、8、12周、6个月、12个月进行X线摄片追踪观察。 结果 18例骨不连11例开放性骨折，术后3个月诱导成骨率79．3％，术后6个月诱导成骨率100％，出现连续性骨痂19例，临床愈合率为65．5％，1年以上达临床愈合标准29例，临床愈合率为100％，13个例骨缺损（骨肿瘤、骨囊肿）术后6个月缺损区完全愈合。 结论：应用生物活性玻璃修复四肢骨缺损，成骨速度快，在很短时间能迅速与骨组织和软组织成紧密连结，具有良好的生物相容性，并在很短时间内产生大量新生骨，骨与生物材料之间的界面稳定性强，是一种理想的替代骨移植修复骨缺损的高生物活性材料。

Objective： To observe clinical of extremities bone fracture， bone healing no－union and bone defects by repaired the osteoglassTM，to explore the mechanism of the bioactive meterial（OsteoglassTM）．Which is the substitute to the bone transplantation，thereby，to provide theory basis of application for the bioactve． Methods 24 patients with bone defects and 18 patients with bone healing adn mon－union were treated． After eliminated the scar tissue and the sclerotic bone at the breakpoint，granules of OsteoglasTM were filled in the medullar cavity． X－ray examine 4，8，12weeks， 6，12 months afeer operation． Results In the treatmen of 18 cases delayed bone healing and mon－union and 11 cases with open fracture，79．3％ three months after poeration Osteoinductive rate was 100％ six months after operation， and 19 cases of continuous callus was observed． The clinical healing rate was 65．5％ and it reached 100％ one year after operation． In the treatment of 13 patients with bone defects completely healing were achieved 6 months after the operation． Conclusion OsteoglassTM repair bone defects of extremities shows rapidity ossification and excellent biocompatibility，it is an ideal bioactive material for bone transplantation and the reparation of bone defects．