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人胎盘来源细胞基质复合松质骨自体移植和脱钙骨基质治疗 2 例感染性骨不连大段长骨骨缺损

Human placenta-derived matrix with cancellous autograft and demineralized bone matrix for large segmental long-bone defects in two dogs with septic nonunion.

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.

J Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida.

出版信息

Vet Surg. 2020 Dec;49(8):1618-1625. doi: 10.1111/vsu.13527. Epub 2020 Oct 3.

DOI:10.1111/vsu.13527
PMID:33009837
Abstract

OBJECTIVE

To report the successful treatment of septic nonunion in two dogs with large segmental defects secondary to long-bone fractures by using a novel human placenta-derived matrix (hPM) as adjunct to fixation.

ANIMALS

One 3-kg 9-year-old neutered male Yorkshire terrier with a distal antebrachial fracture and one 6-kg 4-year-old spayed female miniature pinscher with a distal humeral fracture.

STUDY DESIGN

Short case series.

METHODS

Both dogs presented for septic nonunion after internal fixation of Gustilo type II open diaphyseal fractures from dog bite injuries. During revision, debridement of nonviable bone resulted in segmental defects of 32% and 20% of the bone length for the antebrachial and humeral fractures, respectively. The antebrachial fracture was stabilized with a circular external fixator, and the humeral fracture was stabilized with biaxial bone plating. The fracture sites were not collapsed, and full length was maintained with the fixation. Autogenous cancellous bone graft and canine demineralized bone allograft were packed into the defects, and hPM was injected into the graft sites after closure.

RESULTS

Radiographic union was documented at 8 weeks and 6 weeks for the antebrachial and humeral fractures, respectively. Both dogs became fully weight bearing on the affected limbs and returned to full activity.

CONCLUSION

Augmenting fixation with grafts and hPM led to a relatively rapid union in both dogs reported here.

摘要

目的

报告 2 例因长骨骨折导致大段骨缺损的犬应用新型人胎盘衍生基质(hPM)辅助固定治疗感染性骨不连的成功案例。

动物

1 只为 3kg 的 9 岁雄性已去势约克夏梗犬,发生前臂远端骨折;1 只为 6kg 的 4 岁雌性已去势迷你贵宾犬,发生肱骨远端骨折。

研究设计

简短病例系列研究。

方法

2 只犬均因犬咬伤导致的 Gustilo Ⅱ型开放性骨干骨折行内固定后发生感染性骨不连。在翻修时,对无活力骨进行清创,导致前臂骨和肱骨骨折的骨缺损分别为 32%和 20%的骨干长度。前臂骨折采用环形外固定器固定,肱骨骨折采用双轴骨板固定。骨折部位未塌陷,固定后保持全长。将自体松质骨移植物和犬脱钙骨同种异体移植物填充至缺损部位,关闭后将 hPM 注入移植物部位。

结果

分别在 8 周和 6 周时拍摄 X 线片确认前臂和肱骨骨折愈合。2 只犬患肢均完全负重,恢复正常活动。

结论

本研究中,通过移植物和 hPM 辅助固定,2 只犬均迅速实现愈合。

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