自体骨髓移植联合外固定治疗骨折不愈合

Treatment of bone nonunion by autologous bone marrow combined with external fixation

目的：探讨自体骨髓移植联合外固定治疗骨折不愈合的临床疗效。方法对24例骨折不愈合患者应用自体骨髓移植联合外固定的治疗方法：手术暴露骨折端，切除骨折端坏死组织，然后应用外固定器固定骨折部位，儿童无需切开。2周后拆线行自体骨髓移植，在X线透视下定位骨穿针，自髂后上棘处抽取红骨髓20～30 ml立即注入骨不连部位，共3～4次，每次间隔2周。结果所有患者均完成12个月的随访，随访复查时间为3，6，9，12个月。24例患者均达到骨性愈合，功能恢复良好。骨折愈合时间3～9个月，平均（4.8±2.3）个月。均无骨折移位、畸形、关节功能障碍、外固定断裂、针道感染、支具失效等并发症发生。结论自体骨髓移植联合外固定治疗骨折不愈合能促进骨折快速修复和愈合。

Objective To evaluate clinical results of autologous bone marrow transplantation in combination with external fixation to treat bone nonunion. Methods 24 cases nonunion patients with autologous bone marrow transplantation combined with external fixation to treat. In order to fully expose the fracture, the fracture first processing, and then apply the external fixation to fix the fracture. 2 weeks later autologous bone marrow transplantation was applied, the bone needle localization under X-ray, extract red bone marrow 20 to 30 ml from the posterior superior iliac spine to immediately inject nonunion site in a total of three times at intervals of two weeks. Postoperatively elevate upper limbs to facilitate swelling, using antibiotics to prevent infection. Results Patient follow-up review period was 3, 6, 9, 12 months, all patients completed the 12 months follow-up period. 24 patients are bone healing, and in a good recovery. Healing time 3 to 9 months, the average （4.8±2.3） months. There is no fracture displacement, deformity, joint dysfunction, fracture fixation, pin tract infection occurring. Conclusion It can promote rapid repair and healing by autologous bone marrow transplantation combined with external fixation to treat bone nonunion.