自体髂骨复合骨形态发生蛋白与自体髂骨移植治疗骨折不连接的比较

Comparison between iliac autograft combined with bone morphogenetic protein and iliac autograft for bone nonunion

目的:对比观察自体髂骨复合骨形态发生蛋白移植及单纯自体髂骨移植两种方法治疗骨不连接的临床效果。方法:骨不连接患者40例,男24例,女16例,年龄19～56岁,随机分为两组,实验组20例,对照组20例。实验组行自体髂骨复合骨形态发生蛋白后移植于骨折端;对照组单纯行自体髂骨移植于骨折端。术后随访11～20个月。结果:40例骨不连接患者均进入结果分析。术后X射线片显示所有骨折均获得愈合,实验组骨折临床愈合时间(10.0±3.0)周(8～16周),对照组骨折临床愈合时间(13.0±3.8)周(8～20周),两组比较差异有显著性意义(t=2.26,P<0.05)。结论:自体髂骨复合骨形态发生蛋白治疗骨不连接临床效果优于单纯自体髂骨移植,具有良好的成骨诱导活性,可缩短骨折愈合期,疗效安全、可靠,是治疗骨不连接较好的方法。

OBJECTIVE： To compare the effects of iliac autograft combined with bone morphogenetic protein （BMP） versus iliac autograft alone in treatment of bone nonunion. METHODS： A total of 40 patients suffered nonunion were involved in this study, including 24 male and 16 female, aged 19-56 years. They were randomly divided into an experimental group and a control group, with 20 cases in each group. Experimental group was treated with autologous iliac and BMP-2 implanted into the fracture; Control group was treated with autologous iliac alone implanted into the fracture. All patients were followed up for 11-20 months. RESULTS： A total of 40 cases were included in the final analysis. The X-ray films showed all the nonunions were healed; The experimental group with a mean healing time of （10.0±3.0） weeks （ranged 8 to 16）, and the control group with a mean healing time of （13.0±3.8） weeks （ranged 8 to 20）, with significant differences between the two groups （t=2.26, P 〈 0.05）. CONCLUSION： The iliac autograft combined with BMP-2 is superior to iliac autograft alone in treatment of nonunion. Autologous iliac combined with BMP-2 possess active bone induction properties. This method has the advantages of short fracture healing time, safe and reliable effects, so it is a perfect method to treat nonunion.