骨不连的非手术治疗进展

Progress in non-surgical treatment of bone nonunion

骨不连及骨折延迟愈合是骨科常见的骨折并发症,机械稳定性差和血供障碍是骨折不愈合的重要原因。对不同类型的骨不连,治疗方法也不尽相同。目前主要的治疗方法大致可分为物理治疗,其中低强度脉冲超声疗法、电刺激疗法、高压氧疗法和体外冲击波刺激疗法较为常见;组织工程治疗,包括经皮自体浓缩骨髓注射、干细胞、细胞因子、支架材料;手术治疗,包括钢板固定、髓内钉固定、外固定架等。其中手术治疗为主要方法,随着医学的进一步发展,更多的非手术方法及再生医学也应用于骨不连的治疗中,可以作为单独治疗或作为手术治疗的辅助方法,使骨折不愈合的治疗有更优的选择。

Bone nonunion and delayed fracture healing are common fracture complications in orthopedics.Poor mechanical stability and impaired blood supply are important causes of fracture nonunion.For different types of nonunion,the treatment methods are also different.At the present,the main treatment methods can be divided into physical therapy,including low-intensity pulse ultrasound therapy,electrical stimulation therapy,hyperbaric oxygen therapy and extracorporeal shock wave therapy,tissue engineering therapy,including percutaneous autologous concentrated bone marrow injection,stem cells,cytokines and scaffold materials,and surgical treatment,including plate fixation,intramedullary nail fixation,external fixation frame.At present,surgical treatment is the main method of treatment of bone nonunion.With the development of medicine,more non-surgical methods and regenerative medicine can be used to treat delayed fracture healing.