辅助钢板联合术中及术后自体单采PRP对股骨骨折髓内固定后骨不连愈合的影响  

Effect of Adjuvant Steel Plate Combined with Intraoperative and Postoperative Autologous Platelet-Rich Plasma(PRP)on the Healing of Nonunion after Intramedullary Fixation of Femoral Fractures

作　　者：王大鹏[1] 刘军[2] 张进初[1] Wang Dapeng;Liu Jun;Zhang Jinchu(Department of Orthopedics and Traumatology,Songzi Traditional Chinese Medicine Hospital,Songzi Hubei 434200,China;Department of Orthopedics,Jingzhou Central Hospital,Jingzhou Hubei 434000,China)

机构地区：[1]松滋市中医医院骨伤科,湖北松滋434200 [2]荆州市中心医院骨科,湖北荆州434000

出　　处：《哈尔滨医药》2025年第1期47-49,共3页Harbin Medical Journal

摘　　要：目的旨在探讨辅助钢板与自体单采富血小板血浆(PRP)在股骨骨折髓内固定后骨不连愈合患者中的应用效果。方法根据随机数字表法将38例股骨骨折髓内固定后骨不连患者分为对照组(n=19)和观察组(n=19),对照组保留髓内固定附加重建钢板,并给予术中自体髂骨植骨治疗,观察组在对照组基础上给予术中术后自体单采PRP植于骨缺损部位治疗,比较围术期指标、骨折愈合情况、骨痂形成情况及肢体恢复优良情况。结果观察组围术期指标均低于对照组(t=5.404、4.442、2.729,P<0.05);观察组骨折愈合时间短于对照组(t=3.683,P<0.05),术后6个月骨折愈合率高于对照组(χ^(2)=6.269,P<0.05),但9个月骨折愈合率比较,差异无统计学意义(χ^(2)=1.448,P>0.05);术后1、2、3、6个月,观察组Fernandez-esteve骨痂等级评分均高于对照组(t=6.889、5.985、4.223、5.220,P<0.05),但术后9个月比较差异无统计学意义(t=1.975,P>0.05);术后9个月,两组肢体恢复优良率比较差异无统计学意义(χ^(2)=1.576,P>0.05)。结论在髓内钉辅助钢板基础上,增加术中及术后自体单采PRP以治疗股骨骨折髓内固定后骨不连愈合,可显著减少术中出血量,缩短手术时间,并有效促进骨折愈合及肢体的恢复。Objective To investigate the efficacy of adjuvant steel plate combined with autologous platelet-rich plasma(PRP)in patients with nonunion after intramedullary fixation of femoral fractures.Methods Thirty-eight patients with nonunion after intramedullary fixation of femoral fractures were randomly divided into a control group(n=19)and an observation group(n=19)using a random number table.The control group retained the intramedullary fixation with additional reconstructive steel plate and received intraoperative autologous iliac bone grafting.The observation group,on the basis of the control group,was treated with intraoperative and postoperative autologous PRP implantation at the bone defect site.Perioperative indicators,fracture healing,callus formation,and excellent limb recovery were compared between the two groups.Results The perioperative indicators in the observation group were all lower than those in the control group(t=5.404,4.442,2.729,P<0.05).The fracture healing time in the observation group was shorter than that in the control group(t=3.683,P<0.05),and the fracture healing rate at 6 months postoperatively was higher in the observation group than in the control group(χ^(2)=6.269,P<0.05);however,there was no significant difference in the fracture healing rate at 9 months postoperatively(χ^(2)=1.448,P>0.05).At 1,2,3,and 6 months postoperatively,the Fernandez-Esteve callus grade scores in the observation group were higher than those in the control group(t=6.889,5.985,4.223,5.220,P<0.05),but there was no significant difference at 9 months postoperatively(t=1.975,P>0.05).At 9 months postoperatively,there was no significant difference in the excellent rate of limb recovery between the two groups(χ^(2)=1.576,P>0.05).Conclusion The addition of intraoperative and postoperative autologous PRP to adjuvant steel plate therapy for the treatment of nonunion after intramedullary fixation of femoral fractures can significantly reduce intraoperative blood loss,shorten operative time,and effectively promote fracture h

关 键 词：辅助钢板 富血小板血浆 股骨干骨折 髓内固定 骨不连 

分 类 号：R683.3[医药卫生—骨科学]