长骨骨缺损手术治疗进展

Progress in the surgical treatment of long bone defects

长骨的骨缺损多由高能量损伤 (车祸伤、高处坠落及重物砸伤) 引起,该病治疗困难,周期较长,并发症多,给患者带来了极大的经济、心理及社会压力,严重影响患者的生活质量。若骨缺损范围达到"临界骨缺损长度",即骨干周径的 1.5~2.5 倍或长度的 1 / 10 以上,将超出了骨自行修复的最大能力,缺损不会自行愈合[1]。此时需要手术干预修复大段骨缺损。

The clinical treatment of long bone defects,especially large-segment defects,has always been a difficult problem.At present,the surgical treatment of long bone defects includes bone grafting (autogenous and allogeneic bone transplantation,vascularized or non-vascularized free fibula transplantation),Masquelet,Ilizarov and bone tissue engineering technology.All of these methods have their own advantages and disadvantages.In view of the deficiency of surgical treatment of long bone defects,some innovative and improved measures have emerged in clinic.This article reviews the current surgical treatment of long bone defects and innovations,which are helpful for orthopedic surgeons to choose appropriate surgical methods.