脱钙骨基质治疗长骨骨折延迟愈合及骨不连

Treatment of delayed union and nonunion of long bone fractures by using DBM(decalcified bone matrix)

目的：探讨脱钙骨基质（decalcified bone matrix，DBM）治疗长骨骨折延迟愈合和骨不连的疗效。方法：长骨延迟愈合、骨不连共57例，男45例，女12例；年龄21～65岁，平均42岁。开放性骨折17例，闭合骨折40例。骨折延迟愈合32例中，肱骨4例，股骨10例，胫骨18例；骨不连25例中，肱骨5例，股骨4例，胫骨16例。全部采用DBM于骨断端处和骨缺损区植入治疗。结果：57例患者均获随访，随访时间4～37个月，平均7．8个月。骨折延迟愈合32例中骨折愈合31例，1例胫骨骨折未愈合；骨不连25例中骨折愈合23例，2例未愈合，其中胫骨1例、肱骨1例。愈合时间3～6．6个月，平均4．7个月。结论：DBM治疗长骨骨折延迟愈合及骨不连，其疗效满意、并发症少。

Objective： To discuss the clinical effects of OSTEOSET decalcified bone matrix （DBM） in treatment of delayed union and nonunion of long bone fractures. Methods： Fifty-seven cases of delayed union and nonunion of long bone fractures were treated with Osteoset DBM. There were 45 male and 12 female with average age of 42 years（21 to 65 years）. Among them, there were 17 cases of open fracture and 40 of closed fracture. Thirty-two cases of delayed union included 4 cases of humeral fracture, 10 of femoral fracture and 10 of tibial fracture; twenty-five cases of nonunion included 5 of humeral fracture,4 of femoral fracture and 16 of tibial fracture. All patients were treated by DBM transplantation on the fracture ends and bone defect zone. Results： All 57 cases were followed-up from 4 to 37 months （7.8 months on average）. In 32 cases of delayed union,31 cases got bone union, but 1 case of tibial fracture did nonunion; In 25 cases of nonunion,23 got bone union, but 2 cases did nonunion （ 1 tibial nonunion and 1 humeral nonunion）. The union time was from 3 to 6.6 months（ average 4.7 months）. Conclusion： The treatment of delayed union and nonunion of long bone fractures by using Osteoset DBM has satisfactory effect and lower complications.