骨科修复重建中医用钛网的应用
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摘要
背景:钛网在骨科修复重建治疗中效果良好,已得到广泛的应用。目的:探讨钛网在颅骨缺损、四肢骨缺损、大块胸壁缺损、掌指骨骨折及颌面部骨折等相关骨科疾病应用中的可靠性及优越性。方法:收集钛网在颌面骨缺损、大块胸壁缺损、颅骨缺损、四肢长骨干骨缺损、掌指骨折等骨科疾病修复重建的临床研究及相关实验研究,评价钛网治疗骨科疾病的效果。结果与结论:与其他修复材料相比,钛网在骨科修复重建中有明显的优越性,但作为重建材料尚有一定的缺点,如X射线透光性差等。因此,在骨科应用中应针对不同部位的缺损采用不同的操作方法,以减少并发症的发生和达到更好的修复重建效果。
BACKGROUND: Titanium mesh has good effect in the treatment of orthopedic repair and reconstruction which has been widely used. OBJECTIVE: To explore the reliability and superiority of titanium mesh in the treatment of orthopedic diseases, such as skull defects, bone defects of the limbs, large piece chest wall defects, metacarpal andphalangeal fractures and maxillofacial fracture. METHODS: Clinical and experimental researches on the application of titanium mesh in the repair and reconstruction of orthopedic diseases were collected, including maxillofacial fracture, large piece chest wall defects, skull defects, limb long-bone shaft defects and metacarpal and phalangeal fractures. The effect of titanium mesh for the treatment of orthopedic diseases was evaluated. RESULTS AND CONCLUSION: Compared with other repair materials, titanium mesh has significant advantages in orthopedic repair and reconstruction, but it has certain disadvantages when used as the reconstruction material, such as the poor X-ray translucent. So, during the treatment of orthopedics, defects in different parts should be treated with different methods in order to reduce the incidence of complications and obtain the better effect.
BACKGROUND: Titanium mesh has good effect in the treatment of orthopedic repair and reconstruction which has been widely used. OBJECTIVE: To explore the reliability and superiority of titanium mesh in the treatment of orthopedic diseases, such as skull defects, bone defects of the limbs, large piece chest wall defects, metacarpal andphalangeal fractures and maxillofacial fracture. METHODS: Clinical and experimental researches on the application of titanium mesh in the repair and reconstruction of orthopedic diseases were collected, including maxillofacial fracture, large piece chest wall defects, skull defects, limb long-bone shaft defects and metacarpal and phalangeal fractures. The effect of titanium mesh for the treatment of orthopedic diseases was evaluated. RESULTS AND CONCLUSION: Compared with other repair materials, titanium mesh has significant advantages in orthopedic repair and reconstruction, but it has certain disadvantages when used as the reconstruction material, such as the poor X-ray translucent. So, during the treatment of orthopedics, defects in different parts should be treated with different methods in order to reduce the incidence of complications and obtain the better effect.
引文
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[2]李伦昊,肖彩雯,范先群.钛合金材料在眼眶骨缺损修复中的应用[J].中国实用眼科杂志,2011,29(5):67-69.
[3]Clements JR,Carpenter BB,Pourciau JK.Treating segmental bone defects:a new technique.J Foot Ankle Surg.2008;47(4):350-356.
[4]宁漱岩,乔伟松,刘建国.金属钛网支撑颗粒骨植骨处理人工全髋关节翻修中的髋臼骨缺损[J].中国组织工程研究与临床康复,2009,13(43):8475-8479.
[5]Secchi AG,Grigoriou V,Shapiro IM,et al.RGDS peptides immobilized on titanium alloy stimulate bone cell attachment,differentiation and confer resistance to apoptosis.J Biomed Mater Res A.2007;83(3):577-584.
[6]Spoerke ED,Murray NG,Li H,et al.A bioactive titanium foam scaffold for bone repair.Acta Biomater.2005;1(5):523-533.
[7]Itoh S,Matubara M,Kawauchi T,et al.Enhancement of bone ingrowth in a titanium fiber mesh implant by rhBMP-2and hyaluronic acid.Mater Sci Mater Med.2001;12(7):575-581.
[8]中国知网.中国学术期刊总库[DB/OL].2012-08-10.https://www.cnki.net
[9]SCI数据库.Web of Sciencevia ISI Web of Knowledge[DB/OL].2012-08-10.http://ip-science.thomsonreuters.com/mjl
[10]张晓东,杨维东,宋九余,等.钛网加强的BMSC/松质骨基质修复下颌骨缺损的实验研究[J].临床口腔医学杂志,2003,19(10):582-584.
[11]张开放,闫宏伟,刘凯等.有限接触式钛网管固定材料修复骨缺损的特点[J].中国临床康复,2006,10(33):49-52.
[12]陈跃军.三维分级多孔钛植入体的制备及性能研究[D].四川:西南交通大学,2009:1-110.
[13]Kanayama M,Hashimoto T,Shigenobu K,t al.Pitfalls of anterior cervical fusion using titanium mesh and local autograft.J Spinal Disord Tech.2003;16(6):513-518.
[14]Thongtrangan I,Balabhadra RS,Kim DH.Management of strut graft failure in anterior cervical spine surgery.Neurosurg Focus.2003;15(3):E4.
[15]殷渠东,顾三军,孙振中,等.钛网打压植骨重建四肢长骨节段骨缺损[J].中国组织工程研究,2012,16(48):9096-9100.
[16]尹东芳,黄一飞.医用钛合金的生物相容性研究[J].医学研究杂志,2008,37(10):96-97.
[17]Su JC,Liu XW,Yu BQ,et al.Shape memory Ni-Ti alloy swan-like bone connector for treatment of humeral shaft nonunion.Int Orthop.2010;34(3):369-375.
[18]Lindsey RW,Gugala Z,Milne E,et al.The efficacy of cylindrical titanium mesh cage for the reconstruction of a critical-size canine segmental femoral diaphyseal defect.J Orthop Res.2006;24(7):1438-1453.
[19]Gross AE,Wong P,Saleh KJ.Don't throw away the ring:indications and use.J Arthroplasty.2002;17(4Suppl1):162-166.
[20]Fujibayashi S,Kim HM,Neo M,Uchida M,et al.Repair of segmental long bone defect in rabbit femur using bioactive titanium cylindrical mesh cage.Biomaterials.2003;24(20):3445-3451.
[21]Bullens PH,Bart Schreuder HW,de Waal Malefijt MC,et al.Is an impacted morselized graft in a cage an alternative for reconstructing segmental diaphyseal defects?Clin Orthop Relat Res.2009;467(3):783-791.
[22]Wu X,Liu X,Wei J,et al.19.Nano-TiO(2)/PEEK bioactive composite as a bone substitute material:in vitro and in vivo studies.Int J Nanomedicine.2012;7:1215-1225.
[23]Teixeira CR,Rahal SC,Volpi RS,et al.Tibial segmental bone defect treated with bone plate and cage filled with either xenogeneic composite or autologous cortical bone graft.An experimental study in sheep.Vet Comp Orthop Traumatol.2007;20(4):269-276.
[24]Bullens PH,Schreuder BH,de Waal Malefijt MC,et al.The stability of impacted morsellized bone grafts in a metal cage under dynamic loaded conditions:an in vitro reconstruction of a segmental diaphyseal bone defect.Arch Orthop Trauma Surg.2009;129(5):575-581.
[25]Joffe JM,Nicoll SR,Richards R,et al.Validation of computer-assisted manufacture of titanium plates for cranioplasty.Int J Oral Maxillofac Surg.1999,28(4):309-313.
[26]赵明,方乃成,邵高峰.钛网片修补颅骨缺损40例报告[J].温州医学院学报,2000,30(1):86.
[27]Ostermann PA,Haase N,Rübberdt A,et al.Management of a long segmental defect at the proximal meta-diaphyseal junction of the tibia using a cylindrical titanium mesh cage.J Orthop Trauma.2002;16(8):597-601.
[28]Bullens PH,Hannink G,Verdonschot N,et al.No effect of dynamic loading on bone graft healing in femoral segmental defect reconstructions in the goat.Injury.2010;41(12):1284-1291.
[29]Michiardi A,Hélary G,Nguyen PC,et al.Bioactive polymer grafting onto titanium alloy surfaces.Acta Biomater.2010;6(2):667-675.
[30]张云坤,郁忠杰,贾晓钧,等.钛网植骨修复四肢长骨干骨缺损的实验研究[J].江苏大学学报(医学版),2006,16(4):288-290.
[31]Attias N,Lindsey RW.Case reports:management of large segmental tibial defects using a cylindrical mesh cage.Clin Orthop Relat Res.2006;450:259-266.
[32]Segal U,Shani J.Surgical management of large segmental femoral and radial bone defects in a dog:through use of a cylindrical titanium mesh cage and a cancellous bone graft.Vet Comp Orthop Traumatol.2010;23(1):66-70.
[33]张开放,闫宏伟,刘凯,等.仿生骨植入钛网管固定修复兔骨缺损[J].西安交通大学学报(医学版),2007,28(1):89-92.
[34]张德宝.钛网结合自体骨重建TKA中T3级非包容性胫骨内侧平台骨缺损[DB/OL].2013-01-15.http://t.cn/zY1evQE
[35]Attias N,Lehman RE,Bodell LS,et al.Surgical management of a long segmental defect of the humerus using a cylindrical titanium mesh cage and plates:a case report.J Orthop Trauma.2005;19(3):211-216.
[36]陈启康,李卫,黄继辉,等.木工机械致手外伤的流行病学特点[J].中华手外科杂志,2003,19(2)99-100.
[37]李国臣,王林,桑宏勋,等.可控微结构电子束熔化成形钛合金支架作为成骨细胞载体修复兔骨缺损的研究[J].中华创伤骨科杂志,2010,12(6):557-561.
[38]Zhang Q.Treatment of intra-articular calcaneal fracture by bone grafting and plastic ti-alloy plate internal fixation.Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi.2009;23(6):648-650.
[39]张庆山.可钛网内固定术治疗掌骨折18例分析[J].中国煤炭工业医学杂志,2001,4(4):271-272.
[40]陈启康,李卫,等.钛网在掌指骨骨折治疗中的应用[J].中山大学学报(医学科学版).2009,30(3S):158-160.
[41]宫明智,刘中浩,武士清,等.不同内固定物治疗手掌指骨骨折的疗效比较[J].中华手外科杂志,2005,21(7)538-539.
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