在植入物失败后对压力适合的骨假体进行修改
Jan Paul Frölke1,2, Robin Atallah2,3
1Radboud University Medical Center, Nijmegen, The Netherlands.
JBJS essential surgical techniques
|October 25, 2024
概括
在输骨截肢截肢后,失败的骨假肢的修复涉及一个三阶段的过程. 这包括脱bridement,移除骨整合植入物和重新植入,重点是使用植入物来防止未来的断裂.
科学领域:
- 整形外科手术 整形外科手术
- 生物材料工程是生物材料的工程.
- 假肢和整形手术
背景情况:
- 大约5%的骨移植截肢者使用压合金骨植入物经历了失败.
- 失败是由于败液松动或茎断裂,茎直径和感染是危险因素.
- 2014年从-切换到植入物已经消除了报告的断裂.
研究的目的:
- 为了描述一个三阶段的修订技术,骨固定假肢 (BAP) 失败的转截肢者.
- 详细说明使用定制,3D打印,水冷空洞钻孔进行植入物切除的方法.
- 提供关于在骨整合植入物 (OI) 修改中管理败血栓松动和茎断裂的指导.
主要方法:
- 修复程序包括多达3个阶段:脱bridement,植入物移除和重新植入,阶段之间有10-12周.
- 第1阶段:口的脱皮和移除植入物残留物 (机械故障) 或逆行击与脱皮 (败液松动).
- 第二阶段:使用定制的3D打印,水冷空洞钻孔去除破碎的OI,以保存骨.
- 第三阶段:BAP的修复植入,如果骨库很差,可能会进行骨撞移植 (BIG).
主要成果:
- 与以前的钢芯相比,定制的3D打印芯钻在去除破碎的植入物方面取得了更大的成功.
- 保持足够的骨库存,以便在未来使用所述的移除技术进行修改.
- 自从切换到植入物后,没有报告任何断裂.
结论:
- 描述的三阶段修改技术对于输骨截肢截肢时的骨整合植入物失败是有效的.
- 使用植入物和专用工具,如3D打印的钻,可以改善修改结果.
- 仔细的患者选择和手术规划至关重要,以最大限度地降低复发性失败的风险.
相关概念视频
01:40Bone Remodeling
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
01:27Fractures: Bone Repair
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...