Zheng Yue, Wang Jinliang, Chang Bolun, Zhang Li
Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China.
Department of Orthopedics, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang, Hebei 050011, P.R. China.
Exp Ther Med. 2020 Dec;20(6):233. doi: 10.3892/etm.2020.9363. Epub 2020 Oct 16.
Due to various limitations in the use of autologous bone and allogeneic bone in the repair of bone defects, the use of synthetic bone graft substitute has become a hot topic in orthopedic surgery and repair medicine. A total of 53 patients treated for trauma-induced metacarpal bone defects were recruited. These patients were divided into the TiAlV titanium alloy implantation group (group A) and the autologous bone graft group (group B). The symptoms of patients in the two groups were closely observed and followed up. The operation time, time to bone fusion, post-surgical pain [visual analog scale (VAS) scores], hand function recovery [total active flexion scale (TAFS) scores] and complications were compared between the two groups. Following surgery, none of the patients had necrosis of fingers or bone non-union. The recovery was rated as excellent and good in up to 91.6% of patients, indicating high clinical efficacy. Compared with the use of autologous bone grafting as the gold standard (group B), there was no significant difference in the excellent and good recovery rate based on TAFS scores at 16 weeks after surgery (91.7 vs. 89.7%, P>0.05), and there was also no significant difference in the incidence of post-operative complications (33.3 vs. 41.3%, P>0.05). The operation time (82.08±6.64 min), time to bone fusion (7.75±1.73 weeks) and VAS scores at 3 days after surgery were all significantly lower in group A than in group B (P<0.05). The values of group B were 104.69±8.63 min, 9.17±2.78 weeks and [5(5, 6)], respectively. However, the hospitalization cost (22,657.8±1,595.4Ұ) was significantly higher than that in group B (14,808.2±2,291.3Ұ; P<0.05). In conclusion, the use of titanium alloy implantation may avoid new injury to the donor site, reduce the operation time and post-operative pain and accelerate bone fusion. Therefore, this method is worthy of popularization for defective bone reconstruction and recovery in the clinic.
由于自体骨和异体骨在骨缺损修复应用中存在各种局限性，合成骨移植替代物的应用已成为骨外科和修复医学领域的一个热门话题。共招募了53例因创伤导致掌骨缺损的患者。这些患者被分为钛铝钒钛合金植入组（A组）和自体骨移植组（B组）。对两组患者的症状进行密切观察和随访。比较两组患者的手术时间、骨融合时间、术后疼痛[视觉模拟评分（VAS）]、手部功能恢复情况[总主动屈曲量表（TAFS）评分]及并发症。术后，所有患者均未出现手指坏死或骨不连。高达91.6%的患者恢复情况被评为优或良，表明临床疗效较高。与以自体骨移植作为金标准的B组相比，术后16周基于TAFS评分的优、良恢复率无显著差异（91.7%对89.7%，P>0.05），术后并发症发生率也无显著差异（33.3%对41.3%，P>0.05）。A组的手术时间（82.08±6.64分钟）、骨融合时间（7.75±1.73周）及术后3天的VAS评分均显著低于B组（P<0.05）。B组的值分别为104.69±8.63分钟、9.17±2.78周和[5（5，6）]。然而，住院费用（22657.8±1595.4元）显著高于B组（14808.2±2291.3元；P<0.05）。综上所述，钛合金植入术可避免供区新的损伤，减少手术时间和术后疼痛，并加速骨融合。因此，该方法在临床上用于骨缺损重建和恢复值得推广。
