基于Ⅰ型胶原蛋白和羟基磷灰石的新型仿生人工骨膜修复材料在四肢长骨粉碎性骨折伴游离骨块中的应用

Application of a Novel Biomimetic Artificial Periosteal Repair Material Based on Type I Collagen and Hydroxyapatite in the Treatment of Comminuted Long Bone Fractures of Limbs with Detached Bone Fragments

目的观察基于Ⅰ型胶原蛋白和羟基磷灰石的新型仿生人工骨膜修复材料在四肢长骨粉碎性骨折伴游离骨块中的应用效果。方法选取2021年1月—2022年8月临朐县人民医院因外伤致四肢长骨粉碎性骨折伴游离碎骨块的120例患者作为研究对象,所有患者均行骨折切开复位内固定治疗,根据患者是否同意术中使用人工骨膜修复材料进行分组研究,未使用者纳入对照组(n=54),使用骨膜修复材料者纳入观察组(n=66)。观察两组患者手术时间、术中出血量;术后定期复查X线,进行为期1年的持续随访观察,记录并比较两组患者骨折愈合时间。结果120例患者均顺利完成手术,两组患者术中出血量、手术时间比较,差异无统计学意义(P>0.05);对照组平均骨折愈合时间长于观察组,差异有统计学意义(P<0.05)。对照组骨折延迟愈合、骨折不愈合发生率高于对照组,差异有统计学意义(P<0.05)。结论对四肢长骨粉碎性骨折伴游离骨块中的患者应用人工骨膜修复材可促进骨折的修复愈合,减少骨折延迟愈合及不愈合的发生。

Objective To observe the application effect of a new biomimetic artificial periosteal repair material based on type I collagen and hydroxyapatite in the treatment of comminuted long bone fractures of limbs with detached bone fragments.Methods A total of 120 patients with comminuted fractures of the long bones of the limbs caused by trauma and accompanying detached fragments from January 2021 to August 2022 were selected as the study subjects.All patients underwent open reduction and internal fixation of the fractures,and were divided into groups based on whether the patients agreed to use artificial periosteal repair materials during surgery.No users were included in the control group(54 cases),while those using periosteal repair materials were included in the observation group(66 cases).Observe the surgical time and intraoperative bleeding volume of the two groups of patients;regular postoperative X-ray examinations were conducted,followed up for a period of 1 year,and the healing time of the two groups of patients was recorded and compared.Results All 120 patients successfully completed the surgery,and there was no significant difference in intraoperative bleeding volume and surgical time between the two groups(P>0.05);The average fracture healing time in the control group was higher than that in the observation group,with a statistically significant difference(P<0.05).There were 17 patients in the control group who experienced delayed union of fractures,and ultimately 5 patients were diagnosed with non-union of fractures.The incidence of delayed union and non union of fractures in the control group was higher than that in the control group,the difference between the two groups was statistically significant(P<0.05).Conclusion The application of artificial periosteal repair materials to patients with comminuted fractures of long bones in the limbs accompanied by detached bone blocks can promote the repair and healing of fractures,reduce the occurrence of delayed union and non-union of fractures.