自体骨联合骨形态发生蛋白-2移植治疗骨折术后骨不连的疗效  

Efficacy of Autologous Bone Graft Combined with Bone Morphogenetic Protein-2 in Postoperative Fracture Nonunion

作　　者：刘德淮[1] 白宇[1] 庄小强[1] 陆生林[1] LIU De-huai;BAI Yu;ZHUANG Xiao-qiang;LU Sheng-lin(Department of Orthopaedics,the Affiliated Minzu Hospital of Guangxi Medical University,Nanning 530001,China)

机构地区：[1]广西医科大学附属民族医院骨科

出　　处：《南昌大学学报（医学版）》2019年第5期32-34,47,I0001,共5页Journal of Nanchang University：Medical Sciences

基　　金：广西壮族自治区卫生和计划生育委员会科技计划项目(Z2016152)

摘　　要：目的探讨自体骨联合骨形态发生蛋白-2(BMP-2)移植治疗骨折术后骨不连的临床疗效。方法对2014年1月至2018年3月收治的26例骨折术后骨不连患者采用自体骨联合BMP-2移植治疗。其中男17例,女9例,年龄20~55(42.37±5.14)岁。骨不连部位:肱骨4例,尺骨3例,股骨8例,胫骨11例;骨不连分型:肥大型11例,萎缩型15例。术后即刻,1、2、3、6、12个月行X线检查了解骨折愈合情况,并随访观察并发症发生情况。结果26例患者均获随访,随访6~24(10.6±4.62)个月。骨折愈合时间3~10(5.67±1.54)个月,骨折愈合率为96.15%(25/26)。1例再次发生骨不连;1例膝关节轻度活动受限,可正常行走;2例膝关节中度活动受限,影响深蹲;其余均未发生明显并发症。结论自体骨联合BMP-2移植治疗骨折术后骨不连具有安全性高、生物相容性好、骨愈合率高等优点,值得临床应用。Objective To explore the clinical efficacy of autologous bone graft combined with bone morphogenetic protein-2(BMP-2)in the treatment of postoperative fracture nonunion.Methods Twenty-six patients with postoperative fracture nonunion(17 males and 9 females;20-55(42.37±5.14)years old)were treated with autologous bone graft combined with BMP-2 from January 2014 to March 2018.Among them,nonunion occurred in humerus in 4,in ulna in 3,in femur in 8,and in tibia in 11.The nonunion was hypertrophic in 11 cases and atrophic in 15 cases.X-ray examination was performed to measure the healing of fracture immediately and at 1,2,3,6 and 12 months after operation.In addition,a follow-up was conducted to record the occurrence of complications.Results All the 26 patients were followed up for 6 to 24(10.6±4.62)months.The fracture healing time was 3-10(5.67±1.54)months,and the healing rate was 96.15%(25/26).One case had nonunion again.One case had mild restriction on knee movement but could walk normally.Two cases had moderate restriction on knee movement,which affected the deep squat.No obvious complications were found in other patients.Conclusion Autologous bone graft combined with BMP-2 for postoperative fracture nonunion has the advantages of high safety,good biocompatibility and high bone healing rate.Therefore,the combined treatment is worthy of clinical application.

关 键 词：骨折 骨不连 骨形态发生蛋白-2 自体骨 骨移植 

分 类 号：R687[医药卫生—骨科学]