摘要
目的探讨经皮自体骨髓移植治疗骨折不愈合的疗效。方法治疗患者３１例，男 ２５例，女６例；年龄１８－７７岁，平均２７岁。骨不连部位：防骨７例，腕舟骨１２例，股骨５例，胫骨７例。骨不连时间７－４８个月，平均１３个月。治疗方法：在Ｘ线电视透视下将一枚骨穿针准确穿入骨不连部位，然后抽取自体骼骨红骨髓即刻注入骨不连部位。腕舟骨注射 １０－ １５ ｍｌ，一次即可；四肢长骨注射 ３０－５０ ｍｌ，需 ２－ ３次，间隔 ３－４周。患肢选用合适的固定。结果骨折愈合 ２６例，愈合时间 ５－ ９个月，平均７个月。其中１２例腕舟骨骨不连全部愈合，５例长骨的骨不连未愈合，无感染等并发症发生。结论经皮自体骨髓移植在骨不连部位有成骨作用，对不具备切开植骨条件的长骨骨不连及腕舟骨骨不连病例，可选用经皮自体骨髓移植方法治疗。
Objective To investigate the effect of autogenous hone marrow grafting in the management of nonunion of fractures. Methods Thirty-one patients were treated for nonunion of fractures. There were 7 of the humerus, 12 the carpal scaphoid, 5 the femur and 7 the tibia. The average age of the patients was 27 years (range 18 -- 77 years). The average time from nonunion to percutaneous bone marrow grafting was 13 months (range 7 -- 48 months). The operation was performed under local or general anesthesia. A marrow needle was inserted into the site of the nonunion under the X -- ray, and a total of 10 -- 50 ml of bone marrow was aspirated from the anterior or posterior iliac crest and was injected immediately into the site of nonunion, the limb was then immobilized. During the operation, a total of 10 -- 15 ml of hone marrow was injected into the carpal scaphoid only once, while a total of 30 -- 50 ml of hone marrow was injected into the long bones, and the procedure was repeated after 3 -- 4 weeks. Results Twenty-six of the 31 fractures had union in 7 (5 -- 9) months. All of the 12 carpal scaphoid were healed. Failure occurred in 5 cases, and there was no other complication in this group. Conclusion Percutaneous autogenous bone marrow grafting can play a role in osteogenesis at the site of nonunion. It is a method of choice for the treatment of nonunions of the carpal scaphoid and those fracture nonunions with poor local conditions contraindicated to open surgery.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
1999年第12期709-711,共3页
Chinese Journal of Orthopaedics
关键词
骨折不愈合
骨髓移植
自体移植
Fractures, ununited Bone marrow transplantation Transplantation, autologous
