| 骨形态发生蛋白复合物联合自体骨髓移植治疗四肢长管状骨骨不连 |
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Received:September 25, 2012
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李刚 |
LI Gang |
平湖市中医院骨伤科, 浙江 平湖 314200 |
Department of Orthopaedics and Traumatology, the TCM Hospital of Pinghu, Pinghu 314200, Zhejiang, China |
lg13027230092@sina.com |
| 刘智 |
LIU Zhi |
平湖市中医院骨伤科, 浙江 平湖 314200 |
Department of Orthopaedics and Traumatology, the TCM Hospital of Pinghu, Pinghu 314200, Zhejiang, China |
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| 期刊信息：《中国骨伤》2013年26卷，第4期，第277-280页 |
| DOI：10.3969/j.issn.1003-0034.2013.04.004 |
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目的: 观察骨形态发生蛋白复合物联合自体红骨髓移植治疗四肢长管状骨骨不连的临床疗效。
方法: 自2004年1月至2010年12月, 采用骨形态发生蛋白复合物联合自体红骨髓移植法治疗四肢长管状骨骨不连患者36例, 男22例, 女14例;年龄22～68岁, 平均36.8岁。骨不连部位:肱骨6例, 尺骨4例, 桡骨3例, 股骨10例, 胫骨13例。伤后距治疗时间8～24个月, 平均13.7个月。增生性骨不连22例, 萎缩性骨不连14例。患者主要临床症状为骨折部位负重时疼痛, 肢体肿胀。X线片提示骨折线清晰伴骨缺损。术后通过观察手术切口愈合、植骨区及骨髓穿刺区反应、骨折愈合、邻近的关节功能恢复等情况评估手术疗效。
结果: 术后患者切口均甲级愈合, 未发现过敏和免疫排斥反应。骨髓穿刺区无感染及血肿形成。36例患者均获随访, 时间3～28个月, 平均16.2个月。无骨髓穿刺区慢性疼痛、植骨区骨质感染、切口周围皮肤红肿或窦道形成。骨不连均获得骨性愈合, 愈合时间3～12个月, 平均6.2个月, 无畸形愈合。骨不连愈合后骨折部位负重时疼痛消失、肢体肿胀消退。5例患者遗留邻近关节功能部分受限, 其余患者均完全恢复。
结论: 骨形态发生蛋白复合物联合自体红骨髓移植在治疗四肢长管状骨骨不连中具有来源广泛、安全可靠、加速骨愈合等优点, 是其理想的植骨材料之一。 |
| [关键词]:骨形态发生蛋白类 骨髓移植 骨折 不愈合 四肢 骨折 |
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| Treatment of long bone fracture nonunion in limbs by bone morphogenetic protein compounds combined with autologous red bone marrow graft |
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Abstract:
Objective: To observe the clinical therapeutic effect of treatment for long bone fracture nonunion in limbs by bone morphogenetic protein compounds combined with autologous red bone marrow graft.
Methods: From January 2004 to December 2010,36 cases of long bone fracture nonunion in limbs were treated by bone morphogenetic protein compounds combined with autologous red bone marrow graft. There were 22 males and 14 females with an average age of 36.8 years old ranging from 22 to 68 years. Nonunion sites included humerus in 6 cases,ulna in 4 cases,radius in 3 cases,femur in 10 cases,and tibia in 13 cases. The latest reconstruction was performed on these 36 cases during 8 to 24 months (means 13.7 months) after injuries. There were 22 cases of hypertrophic nonunion,14 cases of atrophic nonunion. Main clinical symptoms were pain of fracture sites on weight bearing and swelling of limbs. Clearness of fracture line and bone defect were indicated on X-ray. The therapeutic effect of the treatment after operation was been evaluated by wound healing,reaction in the area of bone graft and bone marrow aspiration,fracture healing,and recovery of adjacent joint function.
Results: All incisions primarily healed,immunologic rejection and anaphylaxis were not detected in these incisions. Infection and haematoma formation were not detected in the area of bone marrow aspiration. All these 36 cases were followed up for 3 to 20 months (means 16.2 months). Chronic pain in the area of bone marrow aspiration,bone infection in the area of bone graft,and red swelling of the skin near incisions or sinus tract were not detected. Bony union was achieved in all cases in 3 to 12 months (means 6.2 months) after operation,malunion was not detected. Pain of fracture sites on weight bearing and swelling of limbs disappeared after bony union. The adjacent joint function completely recovered in most cases,only 5 cases remained some function limited part.
Conclusion: In the treatment of long bone fracture nonunion in limbs,bone morphogenetic protein compounds combined with autologous red bone marrow graft have the advantage of wide range of sources,safety and promoting bone union,which is one of the ideal bone graft substitute. |
| KEYWORDS:Bone morphogenetic proteins Bone marrow transplantation Fractures,ununited Extremities Fractures |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李刚,刘智.骨形态发生蛋白复合物联合自体骨髓移植治疗四肢长管状骨骨不连[J].中国骨伤,2013,26(4):277~280 |
| 英文格式: | LI Gang,LIU Zhi.Treatment of long bone fracture nonunion in limbs by bone morphogenetic protein compounds combined with autologous red bone marrow graft[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(4):277~280 |
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