血浆和骨髓浓缩物治疗胫腓骨内固定后骨不连  

Local injection of autologous plasma and bone marrow concentrate for treatment of nonunion after internal fixation of tibiofibular fractures

作　　者：张中禹 于丽 林治建 姜泽威 周纪平 姜红江 ZHANG Zhong-yu;YU Li;LIN Zhi-jian;JIANG Ze-wei;ZHOU Ji-ping;JIANG Hong-jiang(Wendeng Orthopedic Hospital,Weihai 264400,China)

机构地区：[1]山东省文登整骨医院,山东威海264400

出　　处：《中国矫形外科杂志》2023年第21期2001-2004,共4页Orthopedic Journal of China

基　　金：国家中医药管理局中医药循证能力建设项目;第三批威海市重点专科(创伤科)项目。

摘　　要：[目的]探讨自体血浆和骨髓浓缩物局部注射治疗胫腓骨内固定后骨不连的临床疗效。[方法] 2018年1月—2022年5月,对58例胫腓骨骨折内固定术后骨不连患者进行自体血浆和骨髓浓缩物局部注射治疗。评估患者的临床与影像资料。[结果] 58例患者顺利完成局部注射治疗,无严重不良反应在,随访2~8个月。至末次随访时,56例患者达到临床骨折愈合的标准,愈合率达到96.6%;2例未愈合患者改行手术植骨治疗。由治疗前至治疗后2个月、治疗后4个月、治疗后6个月和治疗后8个月的时间推移,患者的局部压痛VAS评分[(5.1±0.5),(3.8±0.3),(2.9±0.3),(2.5±0.2),(2.0±0.1),P<0.001]、患肢负重比[(52.0±4.8)%,(59.4±3.5)%,(70.5±3.9)%,(81.4±2.7)%,(93.8±2.1)%,P<0.001]和影像评分[(1.2±0.4),(2.2±0.5),(3.5±0.4),(5.1±0.3),(6.7±0.2),P<0.001]均显著改善。[结论]自体血浆和骨髓浓缩物局部注射是治疗胫腓骨内固定术后骨不连的一种微创治疗技术,具有良好的临床疗效。[Objective] To investigate the clinical efficacy of local injection of autologous plasma and bone marrow concentrate for nonunion after internal fixation of tibiofibular fractures.[Methods] From January 2018 to May 2022,a total of 58 patients received local injection of autologous plasma and bone marrow concentrate for nonunion secondary to internal fixation of tibiofibular fractures.The clinical and imaging data were evaluated.[Results] All the 58 patients underwent local injection therapies smoothly without serious adverse reactions,and were followed up for 2 to 8 months.Up to the last follow-up,56 patients reached the clinical standard of fracture healing,with healing rate of 96.6%,while the remaining 2 patients received open surgeries,including bone grafting for the non-union.From the time point before treatment to 2 months,4 months,6 months and 8 months after treatment,the local tenderness VAS scores [(5.1±0.5),(3.8±0.3),(2.9±0.3),(2.5±0.2),(2.0±0.1),P<0.001],weight-load shearing of the affected limb [(52.0±4.8)%,(59.4±3.5)%,(70.5±3.9)%,(81.4±2.7)%,(93.8±2.1)%,P<0.001] and imaging bone callus score [(1.2±0.4),(2.2±0.5),(3.5±0.4),(5.1±0.3),(6.7±0.2),P<0.001] significantly improved.[Conclusion] Local injection of autologous plasma and bone marrow concentrate is a minimal invasive therapy technique for the nonunion secondary to internal fixation of tibiofibular fractures,with good clinical consequences.

关 键 词：胫腓骨骨折 骨不连 血浆 骨髓浓缩物 局部注射 

分 类 号：R683.42[医药卫生—骨科学]