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冷冻异体手指复合组织移植后的骨关节病变观察

Observations on osteoarthropathy of transplanting frozen composite finger allografts

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【作者】 沈尊理侯明钟陈勤武文森黄燮青贾万新

【Author】 SHEN Zun-Li HOU Ming-Zhong CHEN Qin WU Wen-shen HUANG Xie-qing JIA Wan-xin(Department of Plastic Surgery Shanghai First People’s Hospital Shanghai200080 China)

【机构】 上海市第一人民医院整形科上海市第一人民医院放射线科上海市第一人民医院病理科上海市第一人民医院整形科 上海200080上海200080上海200080

【摘要】 目的研究自体甲皮瓣游离移植包裹冷冻异体手指骨-关节-肌腱-腱鞘复合组织再造、手指后,异体指骨关节病变发生的特点。方法应用X线片和病理活检方法,对16例植入11个月~15年6个月,平均4年5个月的病变异体骨关节进行观察和评价。结果异体骨关节病变过程可分早期(<2年)、中期(2~10年)和晚期(>10年)。X线摄片分别显示软骨下骨虫蛀样缺损、骨关节吸收脱位和毁损;所有的病变骨关节中未见炎性细胞浸润;异体肌腱内见肌腱样细胞生长。结论异体指骨关节病变严重程度与病程有关,其表现类似于失神经关节病变(Charcot关节病)。异体肌腱可长期存活。

【Abstract】 Objective To study the osteoarthropathy of thumbs or fingers reconstructed with a free hallux nail flap and a frozen phalanx-joint-tendon-sheath composite tissue allograft.Methods Using the radiographs and biopsies 16pathologic osteoarticu-lar allografts were evaluated which were transplanted to patients from11months to15years and6months averaging4year and5months .Results The process of pathologic changes of osteoarticular allografts could be divided into three stages early stage <2years middle stage 2-10years and later stage >10years .The radiographs showed wormhole-like defects in the subchondral bone dislo cation and or resorption and destruction of osteoarticular allografts respectively.However infiltra tion of inflammatory cells was not observed in all biopsies.In addition tenocyte-like cells were found within tendon allografts.Con-clusion The severity of the osteoarthropathy was related to the duration of the implantation of allografts.Its characteris tics were similar to those of the neu roarthropathy Charcot joint disease .Long-term survival of tendon allografts was possible.

【关键词】 手指异体移植关节病变
【Key words】 Finger Allograft Arthropathy
  • 【文献出处】 实用手外科杂志 ,Chinese Journal of Practical Hand Surgery , 编辑部邮箱 ,2002年04期
  • 【分类号】R684
  • 【被引频次】7
  • 【下载频次】34
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