Tetzel L, Guyard M
Orthopedic Department, University Children's Hospital Basel, Switzerland.
Orthopedic Department, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France.
Trauma Case Rep. 2020 Dec 13;31:100382. doi: 10.1016/j.tcr.2020.100382. eCollection 2021 Feb.
The management of bone defect due to trauma or surgical debridement is a current problem in orthopedic trauma surgery, often complicated by infection and bone nonunion. The graft is one of the most challenging variables in surgical treatment. Bioactive Glass (BAG) as a biocompatible and osteogenic product is a promising bone substitute showing good results in maxillo-facial-, spine surgery and treatment of osteomyelitis. Surprisingly, there is very little data on BAG use in trauma surgery.
A 51-year-old male patient, involved in a motorcycle accident, suffered an open proximal tibia fracture, type IIIC, of the left leg. Patient was admitted in January of 2013 to a general orthopedic department for surgical treatment. After several surgical revisions due to infection, vascular damage, and bone nonunion, the patient was successfully treated with Masquelet therapy followed by GlassBONE™ grafting (GlassBONE™ 45S5; Norarker). The patient demonstrated excellent results over the course of a two-year follow-up.
In our experience, GlassBONE™ 45S5 has proven to be an effective bone substitute even in difficult grafting conditions, including multiple surgical revisions for bone nonunion and infection. In our case, at the end of 2 years and 3 months of follow-up, the patient reported no pain, and had no signs of infection. Bone union and full weight bearing was achieved.This case report is oriented by the CARE guidelines for clinical case reports; the patient gave consent for publication.
创伤或手术清创导致的骨缺损管理是骨科创伤手术中的一个当前问题，常并发感染和骨不连。移植物是手术治疗中最具挑战性的变量之一。生物活性玻璃（BAG）作为一种生物相容性和成骨产品，是一种有前景的骨替代物，在颌面、脊柱手术和骨髓炎治疗中显示出良好效果。令人惊讶的是，关于BAG在创伤手术中的应用数据非常少。
一名51岁男性患者，因摩托车事故致左小腿开放性胫骨近端骨折，IIIC型。患者于2013年1月入住普通骨科进行手术治疗。因感染、血管损伤和骨不连进行了多次手术翻修后，患者成功接受了Masquelet技术治疗，随后进行了GlassBONE™移植（GlassBONE™ 45S5；Norarker）。在两年的随访过程中，患者显示出极佳的效果。
根据我们的经验，即使在困难的移植条件下，包括因骨不连和感染进行多次手术翻修，GlassBONE™ 45S5已被证明是一种有效的骨替代物。在我们的病例中，随访2年零3个月结束时，患者无疼痛，无感染迹象。实现了骨愈合和完全负重。本病例报告遵循临床病例报告的CARE指南；患者同意发表。
