骨移植替代材料在加速骨折治疗中的应用

具有骨不连倾向的高能骨折,传统的治疗方法是先切开复位内固定,待骨不连发生后,再植骨治疗。这一方法的最大缺点是治疗周期长,二次手术增加了患者的痛苦,且并发症高,不利于早日康复。C harnley早在1961年就提出对此类骨折应早期植骨,以缩短骨愈合时间。近年来,自体骨因取骨量受限、供骨区并发症高,一些生长因子、生物陶瓷以及复合材料等骨移植替代材料,已成为替代自体骨加速骨愈合的早期植入材料。

Enhancement of fracture healing with bone graft substitutes

High-energy fractures are known to result in a long healing proce ss and a high incidence of nonunion. In the traditional treatment of high-energ y fractures, bone grafting or bone substitute grafting is applied only after the delayed union or nonunion has already been confirmed. Secondary interventions t o treat nonunion are associated with a high morbidity of complications and a lon g time recovery. Charnley (1961) first recommended prophylactic bone grafting in treatment of high-energy fractures to reduce total time of fracture healing. H owever, autogenous bone graft has certain drawbacks, such as limited harvest ava ilable and serious complications at the donor site. In order to overcome these p roblems, various bone graft substitutes, such as growth factors, bioceramics and composite grafts, have been developed as early grafting materials.