[1]管宏,胡钢锋,李珍楠,等.骨水泥在老年骨质疏松性肱骨近端骨折治疗中的应用进展[J].中医正骨,2021,33(09):47-51.
　GUAN Hong,HU Gangfeng,LI Zhennan,et al.Advancement of application of bone cements in treatment of osteoporotic proximal humeral fractures in the aged[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(09):47-51.
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骨水泥在老年骨质疏松性肱骨近端骨折治疗中的应用进展()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年09期
页码:
47-51
栏目:
综 述
出版日期:
2021-09-20

文章信息/Info

Title:
Advancement of application of bone cements in treatment of osteoporotic proximal humeral fractures in the aged
作者:
管宏1; 胡钢锋2; 李珍楠1; 徐方琪2; 朱元2
(1.浙江中医药大学第二临床医学院,浙江 杭州 310053; 2.杭州市萧山区第一人民医院,浙江 杭州 311201)
Author(s):
GUAN Hong; HU Gangfeng; LI Zhennan; XU Fangqi; ZHU Yuan
关键词:
肩骨折;  骨质疏松性骨折;  老年人;  骨水泥;  综述
摘要:
随着我国人口老龄化趋势的日益加剧,老年骨质疏松性肱骨近端骨折也逐渐增多。此类骨折因骨密度和骨质量下降导致内固定失败的发生率较高,因此,如何增加骨质疏松性肱骨近端骨折手术治疗中内固定物的稳定性是目前临床上亟待解决的问题。目前临床上治疗此类骨折时,常采用同种异体骨或自体骨移植、骨水泥加强技术等方式来增强螺钉的把持力。其中骨水泥由于其材料容易获得且具有良好的骨传导性、生物相容性及抗压性等特点,逐渐受到临床医生的青睐。本文从骨水泥的类型、注入方式及骨水泥手术的注意事项、弊端等4个方面对骨水泥在老年骨质疏松性肱骨近端骨折治疗中的应用进展进行了综述。

参考文献/References:

[1] SABESAN V J,LOMBARDO D,PETERSEN-FITTS G,et al.National trends in proximal humerus fracture treatment patterns[J].Aging Clin Exp Res,2017,29(6):1277-1283.
[2] SONG H,WANG M,DU H,et al.Comparison of locking plates and intramedullary nails in treatment of three-part or four-part proximal humeral neck fractures in elderly population:a randomized trial protocol[J].Medicine(Baltimore),2020,99(46):e22914.
[3] 郭家良,王海立,董维冲,等.老年肱骨近端骨折的治疗与康复研究进展[J].中华老年骨科与康复电子杂志,2019,5(4):233-237.
[4] 华筠毅,黄伟杰,戴明华,等.髓内钉治疗老年性肱骨近端骨折的疗效评价[J].组织工程与重建外科杂志,2018,14(2): 89-91.
[5] GREENBERG A,ROSINSKY P J,GAFNI N,et al.Proximal humeral nail for treatment of 3- and 4-part proximal humerus fractures in the elderly population:effective and safe in experienced hands[J].Eur J Orthop Surg Traumatol,2021,31(4):769-777.
[6] WALTERS J M,AHMADI S.High-Energy Proximal humerus fractures in geriatric patients:a review[J/OL].Geriatr Orthop Surg Rehabil,2020,11[2021-02-26].https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734485/.DOI:10.1177/2151459320971568.
[7] ASKESEN A,G?#199ER A,UZEL K,et al.Effect of Osteoporosis on Proximal Humerus Fractures[J].Geriatr Orthop Surg Rehabil,2020,11:2151.
[8] R?ERER G,SCOLA A,SCHM?Z W,et al.Biomechanical in vitro assessment of screw augmentation in locked plating of proximal humerus fractures[J].Injury,2013,44(10):1327-1332.
[9] KIM H,LEE W,CHOI S,et al.Role of additional inferomedial supporting screws in osteoporotic 3-part proximal humerus fracture:finite element analysis[J/OL].Geriatr Orthop Surg Rehabil,2020,11[2021-02-26]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649924/.DOI:10.1177/2151459320956958.
[10] KIM D Y,KIM T Y,HWANG J T.PHILOS plate fixation with polymethyl methacrylate cement augmentation of an osteoporotic proximal humerus fracture[J].Clin Shoulder Elb,2020,23(3):156-158.
[11] BIERMANN N,PRALL W C,B?KER W,et al.Augmentation of plate osteosynthesis for proximal humeral fractures: a systematic review of current biomechanical and clinical studies[J].Arch Orthop Trauma Surg,2019,139(8):1075-1099.
[12] BAJAMMAL S S,ZLOWODZKI M,LELWICA A,et al.The use of calcium phosphate bone cement in fracture treatment.A meta-analysis of randomized trials[J].J Bone Joint Surg Am,2008,90(6):1186-1196.
[13] 王云琦,祝静波,姜少华.锁定钢板内固定辅助骨水泥强化治疗老年肱骨近端骨折[J].中国冶金工业医学杂志,2016,33(5):503-504.
[14] CRISTOFOLINI L,RUSPI M L,MARRAS D,et al.Reconstruction of proximal humeral fractures without screws using a reinforced bone substitute[J].J Biomech,2021,115:110138.
[15] VARGA P,INZANA J A,FLETCHER J W A,et al.Cement augmentation of calcar screws may provide the greatest reduction in predicted screw cut-out risk for proximal humerus plating based on validated parametric computational modelling:augmenting proximal humerus fracture plating[J].Bone Joint Res,2020,9(9):534-542.
[16] SIEBENBüRGER G,HELFEN T,BIERMANN N,et al.Screw-tip augmentation versus standard locked plating of displaced proximal humeral fractures:a retrospective comparative cohort study[J].J Shoulder Elbow Surg,2019,28(7):1326-1333.
[17] CHEN L,TANG Y,ZHAO K,et al.Sequential release of double drug(graded distribution)loaded gelatin microspheres/PMMA bone cement[J].J Mater Chem B,2021,9(2):508-522.
[18] 丁国庆,李晓林.老年肱骨近端骨折治疗进展[J].国际骨科学杂志,2011,32(6):372-374.
[19] VERRON E,PISSONNIER M L,LESOEUR J,et al.Vertebroplasty using bisphosphonate-loaded calcium phosphate cement in a standardized vertebral body bone defect in an osteoporotic sheep model[J].Acta Biomater,2014,10(11):4887-4895.
[20] 魏晨旭,何怡文,王聃,等.组织工程学中骨修复材料的研究热点与进展[J].中国组织工程研究,2020,24(10):1615-1621.
[21] GROSFELD E C,HOEKSTRA J W,HERBER R P,et al.Long-term biological performance of injectable and degradable calcium phosphate cement[J].Biomed Mater,2016,12(1):015009.
[22] O’NEILL R,MCCARTHY H O,MONTUFAR E B,et al.Critical review:injectability of calcium phosphate pastes and cements[J].Acta Biomater,2017,50:1-19.
[23] NEWMAN J M,KAHN M,GRUSON K I.Reducing postoperative fracture displacement after locked plating of proximal humerus fractures:current concepts[J].Am J Orthop(Belle Mead NJ),2015,44(7):312-320.
[24] SCHUMACHER M,REITHER L,THOMAS J,et al.Cal-cium phosphate bone cement/mesoporous bioactive glass composites for controlled growth factor delivery[J]. Biomater Sci,2017,5(3):578-588.
[25] GRüNEWALD D,LANGENMAIR E,HIRSCHMüLLER A,et al.Biomechanical in vitro evaluation of a ready-to-use calcium phosphate cement implanted to augment intrame-dullary nail fixation of a three-part humeral head fracture model[J].Proc Inst Mech Eng H,2019,233(7):706-711.
[26] GRADL G,KNOBE M,STOFFEL M,et al.Biomechanical evaluation of locking plate fixation of proximal humeral fractures augmented with calcium phosphate cement[J].J Orthop Trauma,2013,27(7):399-404.
[27] KLEIN R,TETZLAFF R,WEISS C,et al.Osteointegration and resorption of intravertebral and extravertebral calcium phosphate cement[J].Clin Spine Surg,2017,30(3):E291-E296.
[28] LODOSO-TORRECILLA I,VAN DEN BEUCKEN J J J P,JANSEN J A.Calcium phosphate cements:optimization toward biodegradability[J].Acta Biomater,2021,119:1-12.
[29] MARONGIU G,VERONA M,CARDONI G,et al.Synthetic bone substitutes and mechanical devices for the augmentation of osteoporotic proximal humeral fractures:a systematic review of clinical studies[J].J Funct Biomater,2020,11(2):29.
[30] YANG G,LIU J,LI F,et al.Bioactive calcium sulfate/magnesium phosphate cement for bone substitute applications[J].Mater Sci Eng C Mater Biol Appl,2014,35:70-76.
[31] 袁宁,刘运德,李雪,等.庆大霉素和O-羧甲基壳聚糖对硫酸钙骨水泥改性研究[J].中国修复重建外科杂志,2017,31(3):306-312.
[32] SEHLKE B M,WILSON T G,JONES A A,et al.The use of a magnesium-based bone cement to secure immediate dental implants[J].Int J Oral Maxillofac Implants,2013,28(6):357-367.
[33] YOSHIZAWA S,BROWN A,BARCHOWSKY A,et al.Magnesium ion stimulation of bone marrow stromal cells enhances osteogenic activity,simulating the effect of magne-sium alloy degradation[J].Acta Biomater,2014,10(6):2834-2842.
[34] TAN S,WANG Y,DU Y,et al.Injectable bone cement with magnesium-containing microspheres enhances osteogenesis via anti-inflammatory immunoregulation[J].Bioact Mater,2021,6(10):3411-3423.
[35] GULOTTA L V,KOVACEVIC D,YING L,et al.Augmentation of tendon-to-bone healing with a magnesium-based bone adhesive[J].Am J Sports Med,2008,36(7):1290-1297.
[36] SCHENDEL S A,PEAUROI J.Magnesium-based bone cement and bone void filler:preliminary experimental stu-dies[J].J Craniofac Surg,2009,20(2):461-464.
[37] WU Y,TANG X,CHEN J,et al.Improvement of bioactivity,degradability,and cytocompatibility of biocement by addition of mesoporous magnesium silicate into sodium-magnesium phosphate cement[J].J Mater Sci Mater Med,2015,26(9):238.
[38] KANTER B,VIKMAN A,BRüCKNER T,et al.Bone regeneration capacity of magnesium phosphate cements in a large animal model[J].Acta Biomater,2018,69:352-361.
[39] 郭良煜,郭卫春.磷酸镁骨水泥及其复合物在骨修复应用的研究进展[J].医学研究杂志,2019,48(1):159-162.
[40] 张莉,杨在君,丁祥,等.螯合剂对镁基骨水泥体外细胞毒性的影响[J].西华师范大学学报(自然科学版),2016,37(3):270-273.
[41] SIEGEL H J,LOPEZ-BEN R,MANN J P,et al.Pathological fractures of the proximal humerus treated with a proximal humeral locking plate and bone cement[J].J Bone Joint Surg Br,2010,92(5):707-712.
[42] NEER C S 2nd.Displaced proximal humeral fractures. I. classification and evaluation[J].J Bone Joint Surg Am,1970,52(6):1077-1089.
[43] 徐鹏,苏萍,李雪栋,等.锁定接骨板治疗累及肱骨距的肱骨近端骨折:有效支撑、并发症和功能恢复[J].中国组织工程研究,2020,24(12):1949-1956.
[44] 刘炎,葛鸿庆,管华,等.内侧柱缺失型肱骨近端骨折不同固定方式的有限元分析[J].中国组织工程研究,2020,24(9):1384-1389.
[45] UNGER S,ERHART S,KRALINGER F,et al.The effect of in situ augmentation on implant anchorage in proximal humeral head fractures[J].Injury,2012,43(10):1759-1763.
[46] KIYAK G,BALIKCI T,HEYDAR A M,et al.Comparison of the pullout strength of different pedicle screw designs and augmentation techniques in an osteoporotic bone model[J].Asian Spine J,2018,12(1):3-11. 中医正骨2021年9月第33卷第9期 J Trad Chin Orthop Trauma,2021,Vol.33,No.9(总691)(总692)中医正骨2021年9月第33卷第9期 J Trad Chin Orthop Trauma,2021,Vol.33,No.9
[47] MULON P Y,ZARZOSA M,HARPER D P,et al.Assessment of two augmentation techniques on the mechanical properties of titanium cannulated bone screws[J].Am J Vet Res,2020,81(2):116-121.
[48] 佘荣峰,张一,王远政,等.新型骨水泥强化螺钉结合锁定钢板内固定与人工肱骨头置换治疗肱骨近端骨质疏松性骨折的比较[J].中国组织工程研究,2020,24(15):2335-2341.
[49] DONALDSON A J,THOMSON H E,HARPER N J,et al.Bone cement implantation syndrome[J].Br J Anaesth,2009,102(1):12-22.
[50] 冯云升,李万强,陈鹏.骨水泥联合锁定钢板治疗26例老年肱骨近端粉碎性骨折临床疗效观察[J].中国伤残医学,2017,25(20):58-59.
[51] 白刚,刘起,孟令军,等.抗生素骨水泥在软组织缺损中的应用[J].世界最新医学信息文摘(连续型电子期刊),2020,20(62):55-56.
[52] INNES M B,ATWATER A R.Orthopedic implant hypersensitivity reactions:concepts and controversies[J].Dermatol Clin,2020,38(3):361-369.
[53] 吴峰,刘园林,蔡立雄,等.骨水泥增强钢板螺钉固定老年肱骨近端骨折[J].中国矫形外科杂志,2021,29(10):901-905.
[54] XU D,SONG W,ZHANG J,et al.Osteogenic effect of polymethyl methacrylate bone cement with surface modification of lactoferrin[J].J Biosci Bioeng,2021,132(2):132-139.
[55] INCEOGLU S,BOTIMER G,MASKIEWICZ V K.Novel microcomposite implant for the controlled delivery of antibi-otics in the treatment of osteomyelitis following total joint replacement[J].J Orthop Res,2021,39(2):365-375.

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备注/Memo

备注/Memo:
基金项目:浙江省医药卫生科技计划项目(2020KY794); 萧山区科技计划项目(2017203)
通讯作者:胡钢锋 E-mail:13758191112@163.com
更新日期/Last Update: 1900-01-01