自体深筋膜复合自体红骨髓移植治疗骨不连

Deep fascia composite autologous red bone marrow transplantation for the treatment of fracture nonunion

目的:根据膜引导性骨再生与骨诱导再生的理论,将自体深筋膜复合自体红骨髓移植治疗骨不连,为临床寻找一种简便有效的治疗骨不连的方法。方法:自2006年3月至2009年3月,采用自体深筋膜复合自体红骨髓移植的方法对17例骨不连患者进行治疗,男10例,女7例;年龄7～52岁,平均32岁;胫骨10例,桡骨5例,锁骨2例。受伤至入院时间7～36个月,平均12个月。入院前已手术1次者10例,2次者5例,3次者2例。骨不连部位均位于骨干,皮肤软组织条件较好。X线片显示增生性骨不连11例,萎缩性骨不连6例。均拆除原有内固定物,重新用髓内钉或钢板内固定,并用自体深筋膜密闭缝合骨折端,内注入自体红骨髓。结果:17例患者均获得随访,时间5个月～2年,平均1年。骨折临床愈合时间12～20周,平均16周。术后根据骨折愈合标准对疗效进行评估:优14例,良2例,差1例。结论:自体深筋膜复合自体红骨髓移植治疗骨不连,骨折愈合时间短,适合于骨不连位于骨干,皮肤软组织条件较好的患者。

Objective：According to bone regeneration under the membrane and the bone regeneration deep fascia composite autologous red bone marrow transplantation applied in the treatment of fracture nonunion,in order to find a simple and effective clinical treatment of nonunion. Methods：Since March 2006 to March 2009,17 patients of fracture nonunion were treated by the deep fascia composite autologous bone marrow transplantation,included 10 males and 7 females,aged from 7 to 52 years old（means 32 years）. There were 10 cases of tibia,5 cases of radius,2 cases of clavicle. Injured to admission time was from 7 to 36 months （means 12 months）. Ten cases underwent operation for 1 time,5 cases for twice and 2 cases for 3 times. The position of nonunion were all at bone shaft and the condition of the skin and soft tissue was good. X ray film showed 11 cases of hyperplasia nonunion,6 cases of shrinking. The original fixation were removed and the intramedullary nail or plate fixation were re used,and fracture ends were sutured closed by autogenous deep fascia and implanted with autologous red bone marrow. Results：Seventeen patients were followed up for from 5 months to 2 years with an average of 1 year. Fracture healing time was from 12 to 20 weeks （means 16 weeks）. According to the criteria of fracture healing to assess efficacy,the results were excellent in 14 cases,good in 2 cases and poor in 1 case. Conclusion：Deep fascia composite autologous autologous red bone marrow transplantation for the treatment of fracture nonunion is suitable at the bone shaft and good condition of skin and soft tissue. The method has been observed that the fracture healing time is short.