带锁髓内钉内固定加经皮注射红骨髓治疗肱骨骨不连

Treatment of humeral shaft nonunion with interlocking nail and percutaneous injection of bone marrow

目的 探讨采用Russell Taylor扩髓型带锁髓内钉顺行内固定与植骨、术后注射红骨髓治疗肱骨骨不连。 方法 肱骨骨不连患者 2 5例 ,以往平均手术次数 2次 ,骨折后时间 10个月～ 4年 ,平均 1年 10个月。用带锁髓内钉顺行静力型固定骨折端 ,取自体髂骨植修复骨缺损。术后 10d于骨折区注射自体红骨髓。术后早期功能锻炼。平均随访时间 16个月。 结果 所有病例均达到骨性愈合 ,平均愈合时间 4 5个月 ,关节功能恢复良好。 结论 带锁髓内钉内固定加经皮注射红骨髓治疗肱骨骨不连 ,可提供坚强的内固定 ,利于骨不连的愈合和功能的恢复 ;经皮注射红骨髓可补充成骨前质细胞 。

Objective To investigate the effect of treatment of humeral shaft nonunion with interlocking nail and percutaneous injection of bone marrow after operation. Methods Twenty five adult patients with humeral shaft nonunion, initially treated with plates, intramedullary nails, or external fixtors changed to use RussellTaylor reamed antegrade intramedullary nails with autologous bone grafting and percutaneously bone marrow injection into the fracture sites ten days after the operation to promote union. Results All paients achieved a solid union with good function. The union period was a median of 4 5 months. Conclusion We believe that the procedure may provide firm internal fixation and improve activity of osteoblasts in fracture sites for accelerating fracture healing.