冷冻异体手指复合组织移植后的骨关节病变观察

目的 研究自体Mu甲皮瓣游离移植包裹冷冻异体手指骨－关节－肌腱－腱鞘复合组织再造Mu，手指后，异体指骨关节病变发生的特点。方法 应用X线片和病理活检方法，对16例植入11个月－15年6个月，平均4年5个月的病变异体骨关节进行观察和评价。结果 异体骨关节病变过程可分早期（＜2年），中期（2－10年）和晚期（＞10年）。X线摄片分别显示软骨下骨虫蛀样缺损，骨关节吸收脱位和毁损。所有的病变骨关节中未见炎性细胞浸润，异体肌腱内见肌腱样细胞生长。结论 异体指骨关节病变严重程度与病程有关，其表现类似于失神经关节病变（Charcot关节病）。异体肌腱可长期存活。

Observations on osteoarthropathy of transplanting frozen composite finger allografts

Objective To study the osteoarthropathy of thumbs or fingers reconstructed with a free hallux nail flap and a frozen phalanx-joint-tendon-sheath composite tissue allograft.Methods Using the radiographs and biopsies 16pathologic osteoarticu-lar allografts were evaluated which were transplanted to patients from11months to15years and6months averaging4year and5months .Results The process of pathologic changes of osteoarticular allografts could be divided into three stages early stage <2years middle stage 2-10years and later stage >10years .The radiographs showed wormhole-like defects in the subchondral bone dislo cation and or resorption and destruction of osteoarticular allografts respectively.However infiltra tion of inflammatory cells was not observed in all biopsies.In addition tenocyte-like cells were found within tendon allografts.Con-clusion The severity of the osteoarthropathy was related to the duration of the implantation of allografts.Its characteris tics were similar to those of the neu roarthropathy Charcot joint disease .Long-term survival of tendon allografts was possible.