颅骨游离骨瓣愈合的影响因素
Factors Influencing the Healing of Free Skull Bone Flap
DOI: 10.12677/jcpm.2025.42274, PDF,   
作者: 刘 忆, 尹 钦, 杨 刚*：重庆医科大学附属第一医院神经外科，重庆
关键词: 颅骨游离骨瓣；骨愈合；骨瓣移植；Free Skull Bone Flap； Bone Healing； Bone Flap Transplantation
摘要: 由于自体骨瓣具有良好的组织相容性、易于获取以及能够实现原位重建等优点，颅骨游离骨瓣在颅面外科及神经外科中得到了广泛应用。尽管游离骨瓣存在缺乏血供、可能被吸收的风险，但在实际临床应用中，大多数游离颅骨骨瓣能够成功生长并愈合，愈合过程受到多种因素的影响。本文旨在对游离颅骨瓣移植后愈合的影响因素进行文献综述。
Abstract: Free cranial bone flap is widely used in craniofacial surgery and neurosurgery because of its good histocompatibility, easy access and in situ reconstruction. Due to the lack of blood supply, the free bone flap has the risk of absorption. However, in practical clinical application, most of the free skull bone flap can grow and heal, and the healing process is affected by various factors. In this paper, the influencing factors of healing after free cranial flap transplantation were reviewed.
文章引用：刘忆, 尹钦, 杨刚. 颅骨游离骨瓣愈合的影响因素[J]. 临床个性化医学, 2025, 4(2): 1030-1034. https://doi.org/10.12677/jcpm.2025.42274

参考文献

[1] 马伦昆, 张智勇. 颅骨游离骨瓣移植后成活机制的研究进展[J]. 组织工程与重建外科, 2021, 17(3): 266-268.
[2] Giannoudis, P.V., Einhorn, T.A. and Marsh, D. (2007) Fracture Healing: The Diamond Concept. Injury, 38, S3-S6. [Google Scholar] [CrossRef] [PubMed]
[3] Lu, C., Saless, N., Hu, D., Wang, X., Xing, Z., Hou, H., et al. (2011) Mechanical Stability Affects Angiogenesis during Early Fracture Healing. Journal of Orthopaedic Trauma, 25, 494-499. [Google Scholar] [CrossRef] [PubMed]
[4] Jagodzinski, M. and Krettek, C. (2007) Effect of Mechanical Stability on Fracture Healing—An Update. Injury, 38, S3-S10. [Google Scholar] [CrossRef] [PubMed]
[5] Lienau, J., Schell, H., Duda, G.N., Seebeck, P., Muchow, S. and Bail, H.J. (2005) Initial Vascularization and Tissue Differentiation Are Influenced by Fixation Stability. Journal of Orthopaedic Research, 23, 639-645. [Google Scholar] [CrossRef] [PubMed]
[6] Glatt, V., Evans, C.H. and Tetsworth, K. (2017) A Concert between Biology and Biomechanics: The Influence of the Mechanical Environment on Bone Healing. Frontiers in Physiology, 7, Article 678. [Google Scholar] [CrossRef] [PubMed]
[7] Augat, P., Hollensteiner, M. and von Rüden, C. (2021) The Role of Mechanical Stimulation in the Enhancement of Bone Healing. Injury, 52, S78-S83. [Google Scholar] [CrossRef] [PubMed]
[8] Claes, L.E., Heigele, C.A., Neidlinger-Wilke, C., Kaspar, D., Seidl, W., Margevicius, K.J., et al. (1998) Effects of Mechanical Factors on the Fracture Healing Process. Clinical Orthopaedics and Related Research, 355, S132-S147. [Google Scholar] [CrossRef] [PubMed]
[9] Özerdem, Ö.R., Anlatici, R., Bahar, T., Kayaselçuk, F., Barutçu, Ö., Tuncer, I., et al. (2003) Roles of Periosteum, Dura, and Adjacent Bone on Healing of Cranial Osteonecrosis. Journal of Craniofacial Surgery, 14, 371-379. [Google Scholar] [CrossRef] [PubMed]
[10] Gosain, A.K., Gosain, S.A., Sweeney, W.M., Song, L. and Amarante, M.T.J. (2011) Regulation of Osteogenesis and Survival within Bone Grafts to the Calvaria: The Effect of the Dura versus the Pericranium. Plastic and Reconstructive Surgery, 128, 85-94. [Google Scholar] [CrossRef] [PubMed]
[11] Zhai, Y., Zhou, Z., Xing, X., Nuzzle, M. and Zhang, X. (2025) Differential Bone and Vessel Type Formation at Superior and Dura Periosteum during Cranial Bone Defect Repair. Bone Research, 13, Article No. 8. [Google Scholar] [CrossRef] [PubMed]
[12] Lemperle, S.M., Calhoun, C.J., Curran, R.W. and Holmes, R.E. (1998) Bony Healing of Large Cranial and Mandibular Defects Protected from Soft-Tissue Interposition: A Comparative Study of Spontaneous Bone Regeneration, Osteoconduction, and Cancellous Autografting in Dogs. Plastic and Reconstructive Surgery, 101, 660-672. [Google Scholar] [CrossRef] [PubMed]
[13] Marupanthorn, K., Tantrawatpan, C., Kheolamai, P., Tantikanlayaporn, D. and Manochantr, S. (2017) Bone Morphogenetic Protein-2 Enhances the Osteogenic Differentiation Capacity of Mesenchymal Stromal Cells Derived from Human Bone Marrow and Umbilical Cord. International Journal of Molecular Medicine, 39, 654-662. [Google Scholar] [CrossRef] [PubMed]
[14] Sheng, M.H.-C., Zhou, X., Bonewald, L.F., Baylink, D.J. and Lau, K.-H.W. (2013) Disruption of the Insulin-Like Growth Factor-1 Gene in Osteocytes Impairs Developmental Bone Growth in Mice. Bone, 52, 133-144. [Google Scholar] [CrossRef] [PubMed]
[15] Ritz, M., Graumann, U., Gutierrez, B., Hausmann, O. and E, (2010) Traumatic Spinal Cord Injury Alters Angiogenic Factors and TGF-Beta1 That May Affect Vascular Recovery. Current Neurovascular Research, 7, 301-310. [Google Scholar] [CrossRef] [PubMed]
[16] 刘松, 李文斌, 邵国, 张春阳, 冯士军. 硬脑膜在颅骨/脑膜/脑组织系统生长发育中的作用机制研究进展[J]. 天津医药, 2024, 52(11): 1226-1232.
[17] 寇正雄, 张海燕, 侯晓峰, 张占阅, 张安龙, 梅小龙, 叶小健, 张春阳. 硬脑膜对颅骨生长影响的研究进展[J]. 中国医刊, 2021, 56(10): 1059-1062.
[18] Hobar, C.P., Schreiber, J.S., McCarthy, J.G. and Thomas, P.A. (1993) The Role of the Dura in Cranial Bone Regeneration in the Immature Animal. Plastic and Reconstructive Surgery, 92, 405-410. [Google Scholar] [CrossRef] [PubMed]
[19] Gosain, A.K., Santoro, T.D., Song, L., Capel, C.C., Sudhakar, P.V. and Matloub, H.S. (2003) Osteogenesis in Calvarial Defects: Contribution of the Dura, the Pericranium, and the Surrounding Bone in Adult versus Infant Animals. Plastic and Reconstructive Surgery, 112, 515-527. [Google Scholar] [CrossRef] [PubMed]
[20] Greenwald, J.A., Mehrara, B.J., Spector, J.A., Fagenholz, P.J., Saadeh, P.B., Steinbrech, D.S., et al. (2000) Immature versus Mature Dura Mater: II. Differential Expression of Genes Important to Calvarial Reossification. Plastic and Reconstructive Surgery, 106, 630-638. [Google Scholar] [CrossRef] [PubMed]
[21] Lowery, J.W. and Rosen, V. (2018) The BMP Pathway and Its Inhibitors in the Skeleton. Physiological Reviews, 98, 2431-2452. [Google Scholar] [CrossRef] [PubMed]
[22] Yazici, C., Takahata, M., Reynolds, D.G., Xie, C., Samulski, R.J., Samulski, J., et al. (2011) Self-Complementary AAV2.5-BMP2-Coated Femoral Allografts Mediated Superior Bone Healing versus Live Autografts in Mice with Equivalent Biomechanics to Unfractured Femur. Molecular Therapy, 19, 1416-1425. [Google Scholar] [CrossRef] [PubMed]
[23] Burkus, J.K., Hei, S.E., Gornet, M.F. and Zdeblick, T.A. (2004) The Effectiveness of rhBMP-2 in Replacing Autograft: An Integrated Analysis of Three Human Spine Studies. Orthopedics, 27, 723-728. [Google Scholar] [CrossRef] [PubMed]
[24] Guo, Y., Yuan, Y., Wu, L., Ho, T., Jing, J., Sugii, H., et al. (2018) BMP-IHH-Mediated Interplay between Mesenchymal Stem Cells and Osteoclasts Supports Calvarial Bone Homeostasis and Repair. Bone Research, 6, Article No. 30. [Google Scholar] [CrossRef] [PubMed]
[25] Vural, A.C., Odabas, S., Korkusuz, P., Yar Sağlam, A.S., Bilgiç, E., Çavuşoğlu, T., et al. (2016) Cranial Bone Regeneration via BMP-2 Encoding Mesenchymal Stem Cells. Artificial Cells, Nanomedicine, and Biotechnology, 45, 544-550. [Google Scholar] [CrossRef] [PubMed]
[26] Zhou, T., Wang, F., Liu, K., Zhou, H. and Shang, J. (2024) An Injectable Carboxymethyl Chitosan-Based Hydrogel with Controlled Release of BMP-2 for Efficient Treatment of Bone Defects. International Journal of Biological Macromolecules, 282, Article 137120. [Google Scholar] [CrossRef] [PubMed]
[27] Durham, E.L., Howie, R.N., Hall, S., Larson, N., Oakes, B., Houck, R., et al. (2018) Optimizing Bone Wound Healing Using BMP2 with Absorbable Collagen Sponge and Talymed Nanofiber Scaffold. Journal of Translational Medicine, 16, Article No. 321. [Google Scholar] [CrossRef] [PubMed]
[28] Zhang, C., Li, L., Feng, K., Fan, D., Xue, W. and Lu, J. (2017) ‘Repair’ Treg Cells in Tissue Injury. Cellular Physiology and Biochemistry, 43, 2155-2169. [Google Scholar] [CrossRef] [PubMed]
[29] Ono, T. and Takayanagi, H. (2017) Osteoimmunology in Bone Fracture Healing. Current Osteoporosis Reports, 15, 367-375. [Google Scholar] [CrossRef] [PubMed]
[30] Okamoto, K., Nakashima, T., Shinohara, M., Negishi-Koga, T., Komatsu, N., Terashima, A., et al. (2017) Osteoimmunology: The Conceptual Framework Unifying the Immune and Skeletal Systems. Physiological Reviews, 97, 1295-1349. [Google Scholar] [CrossRef] [PubMed]
[31] Einhorn, T.A. and Gerstenfeld, L.C. (2014) Fracture Healing: Mechanisms and Interventions. Nature Reviews Rheumatology, 11, 45-54. [Google Scholar] [CrossRef] [PubMed]
[32] Al-Sebaei, M.O., Daukss, D.M., Belkina, A.C., Kakar, S., Wigner, N.A., Cusher, D., et al. (2014) Role of Fas and Treg Cells in Fracture Healing as Characterized in the Fas-Deficient (Lpr) Mouse Model of Lupus. Journal of Bone and Mineral Research, 29, 1478-1491. [Google Scholar] [CrossRef] [PubMed]
[33] Chen, R., Zhang, X., Li, B., Tonetti, M.S., Yang, Y., Li, Y., et al. (2024) Progranulin-Dependent Repair Function of Regulatory T Cells Drives Bone-Fracture Healing. Journal of Clinical Investigation, 135, e180679. [Google Scholar] [CrossRef] [PubMed]
[34] 苟茂荣. 蝶骨平台-鞍结节-鞍底微骨瓣在经鼻内镜入路颅底重建中的结局及影响因素研究[D]: [硕士学位论文]. 延安: 延安大学, 2024.
[35] 周卓亚. 原位骨瓣在内镜扩大经蝶入路颅底重建的应用[D]: [硕士学位论文]. 重庆: 重庆医科大学, 2021.