两种植骨材料在桡骨远端骨折治疗中的应用效果比较

Comparison of application efficacy of two bone graft materials in the treatment of distal radius fractures

目的比较自固化磷酸钙人工骨植骨与同种异体骨植骨在桡骨远端骨折治疗中的应用效果。方法将120例基线资料匹配成功的桡骨远端骨折患者采用切开复位掌侧锁定钢板内固定及植骨术治疗,按照植骨材料不同分为A组(采用自固化磷酸钙人工骨植骨,60例)和B组(采用同种异体骨植骨,60例)。记录两组术后抗生素使用时间、拆线时间、住院时间、切口甲级愈合率、术后并发症发生率及术后12个月的骨折临床愈合率、影像学指标、腕关节活动度。采用Gartland-Werley评分评价腕关节功能。结果患者均获得12个月随访。术后抗生素使用时间、拆线时间、住院时间、切口甲级愈合率、术后并发症发生率及术后12个月腕关节尺偏、桡偏活动度A组均明显优于B组(P<0.05);术后12个月的骨折临床愈合率、腕关节背伸及掌屈活动度、影像学指标两组比较差异均无统计学意义(P>0.05)。术后12个月采用Gartland-Werley评分评价的腕关节功能优良率A组明显高于B组(P<0.01)。结论在切开复位掌侧锁定钢板内固定治疗桡骨远端骨折时,采用自固化磷酸钙人工骨植骨在切口愈合及腕关节功能恢复方面优于同种异体骨植骨,可明显修复骨质缺损,维持骨折复位,对促进骨折愈合具有积极作用。

Objective To compare the application efficacy of self-solidifying calcium phosphate cement(CPC)and allograft bone in the treatment of distal radius fracture.Methods According to different bone grafting materials,the 120 patients of distal radius fractures whose baseline data were matched successfully,were adopted with open reduction and internal fixation with volaRlocking plate and bone grafting,were divided into group A(60 cases who received CPC artificial bone graft)and group B(60 cases who underwent allograft bone graft).The postoperative antibiotic use time,the suture removal time,the length of hospitalization,the first class healing rate of incision,the postoperative complication incidence rate,and the clinical healing rate of fracture,imaging indexes and the wrist range of motion at 12 months afteRoperation were recorded.Gartland-Werley score was used to evaluate wrist joint function.Results All cases were followed up foR12 months.Group A was significantly betteRthan group B,including the postoperative antibiotic use time,the suture removal time,the length of hospitalization,the first class healing rate of incision,the postoperative complication rate,and the range of motion of the ulnaRinclination and radial inclination of wrist joint(P<0.05).At 12 months postoperation,there were no statistically significant differences in the clinical fracture healing rate,wrist dorsiflexion and palmaRflexion range of motion,and imaging indictors between the two groups(P>0.05);the excellent-good rate of wrist function in group A was significantly higheRthan that in group B(P<0.01).Conclusions In the open reduction and internal fixation with volaRlocking plate foRdistal radius fractures,the use of CPC is betteRthan allograft bone in terms of incision healing and wrist joint function recovery,CPC can significantly repaiRbone defects and maintain fracture reduction.It has a positive effect on promoting fracture healing.