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经皮自体骨髓治疗儿童四肢长骨干骨折术后骨延迟愈合
Percutaneous autogenous bone marrow transplantation treats delayed union of diaphyseal fracture in extremity long bone among children
- 第三军医大学学报 2017年39卷第6期 页码：574-578
- 作者机构：
400014 重庆，重庆医科大学附属儿童医院骨一科，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室，重庆市儿童发育重大疾病诊治与预防国际科技合作基地
- 作者简介：
[刘星,E-mail:liuxingda@126.com Liu Xing, E-mail: liuxingda@126.com
- 基金信息：国家临床重点专科建设项目(国卫办医函 (2013)544);重庆市卫生和计划生育委员会重点项目(渝卫科教 (2013)39号2013-1-029)
DOI：10.16016/j.1000-5404.201610053
中图分类号： R457.7;R619;R726.843收稿：2016-10-10，
修回：2016-11-29，
纸质出版：2017-06
- 稿件说明：
移动端阅览
郭宏溪, 刘星, 李明, 等. 经皮自体骨髓治疗儿童四肢长骨干骨折术后骨延迟愈合[J]. 第三军医大学学报, 2017,39(6):574-578.
Hongxi Guo, Xing Liu, Ming Li, et al. Percutaneous autogenous bone marrow transplantation treats delayed union of diaphyseal fracture in extremity long bone among children[J]. Journal of Third Military Medical University, 2017, 39(6): 574-578.
郭宏溪, 刘星, 李明, 等. 经皮自体骨髓治疗儿童四肢长骨干骨折术后骨延迟愈合[J]. 第三军医大学学报, 2017,39(6):574-578. DOI： 10.16016/j.1000-5404.201610053.
Hongxi Guo, Xing Liu, Ming Li, et al. Percutaneous autogenous bone marrow transplantation treats delayed union of diaphyseal fracture in extremity long bone among children[J]. Journal of Third Military Medical University, 2017, 39(6): 574-578. DOI： 10.16016/j.1000-5404.201610053.
摘要
目的
2
探讨经皮自体骨髓移植治疗儿童四肢长骨干骨折术后骨延迟愈合的优越性、安全性及疗效。
方法
2
2006-2014年我院应用经皮自体骨髓移植治疗的四肢长骨干骨折术后骨延迟愈合患儿53例 (骨折端均稳定、无严重成角和短缩畸形)，男性35例，女性18例，年龄1~16岁，平均年龄6.7岁。骨折部位：股骨20例，胫骨12例，肱骨10例，桡骨5例，尺骨5例，单纯腓骨1例，均为外伤性骨折术后骨延迟愈合。按照骨折术后至第1次骨髓移植的时间分组，4~6个月共23例作为A组，6~8个月共30例作为B组。从髂前上棘处抽吸骨髓穿刺抽取骨髓液5~20 mL，平均12.7 mL，经皮注入到X线定位的骨折延迟愈合处。术后定期摄X线片，观察、比较骨折愈合情况。
结果
2
本组所有骨折延迟愈合均获得随访，并随访至拆除内、外固定后至少6个月，最终47例获临床愈合，愈合时间距第1次骨髓移植后3~10个月，平均5.8个月。未愈合6例，A组1例，B组5例，骨髓移植2次后骨折处无明显骨痂生长，改为其他方法治疗。两组愈合时间和骨髓注射次数比较差异均有统计学意义 (
P
<
0.01)，两组最终治愈率比较差异无统计学意义 (
P
>
0.05)。
结论
2
经皮自体骨髓移植治疗儿童四肢长骨干骨折术后骨延迟愈合是一种操作简单、微创、安全、经济又切实可行的治疗方法，且早期行自体骨髓移植，可加快骨折愈合，缩短疗程，值得临床推广。
Abstract
Objective
2
To investigate the effectiveness
advantages
and safety of delayed union of diaphyseal fracture of extremity long bone in children after the treatment with percutaneous autogenous bone marrow transplantation.
Methods
2
From 2006 to 2014
53 patients (stable fracture fixation and no serious angular and short deformity) with delayed union of diaphyseal fracture of extremity long bone after operation
including 35 males and 18 females
were enrolled in this study
They were at an age ranged from 1 to 16 years old with a mean age of 6.7 years old. All the cases were traumatic fractures
involving 20 cases of the femur
12 cases of tibia
10 cases of humerus
5 cases of radius
5 cases of ulna
and 1 case of simple fibular. According to the time from the operation to the first bone marrow transplantation
23 patients with the time of 4~6 months were assigned as group A
and 30 patients with the time of 6~8 months were assigned as group B. The patients were placed by prostration and 5~20 mL (average 12.7 mL) bone marrow was aspirated from the anterior superior iliac spine. Then the bone marrow was injected into the delayed union site under fluoroscopic control. X-ray filming was used to observe the fracture healing.
Results
2
All patients were followed up for at least 6 months after internal and external fixation was removed. Finally 47 cases achieved clinical healing at a mean time of 5.8 months after operation (from 3 months to 10 months). Failure occurred in 6 cases
including 1 case in group A and 5 cases in group B. After 2 injections
no obvious bony callus was observed
and then other treatment was performed. There were statistically significant differences in healing time and the number of injections between the 2 groups (
P
<
0.01). The total curative rates of the 2 groups had no statistical significance (
P
>
0.05).
Conclusion
2
Percutaneous autogenous bone marrow transplantation is a simple
safe
minimally invasive
economical and feasible method for the treatment of delayed union of diaphyseal fracture of extremity long bone in children after operation. What is more
the early bone marrow transplantation can accelerate the fracture healing and shorten the course of treatment.
关键词
Keywords
references
Giannoudis P V, Panteli M, Calori G M. Bone healing: the diamond concept[J]. European Instructional Lectures, 2014, 14: 3-16. DOI:10.1007/978-3-642-54030-1_1
Bhutia K U, Bary A A, Raghu Vanshi G, et al. Role of percutaneous autologous bone marrow injection in treatment of delayed union and non union of long bones[J]. IOSR Journal of Dental and Medical Sciences, 2015, 14(1): 7-13
Calori G M, Colombo M, Mazza E L, et al. Validation of the Non-Union Scoring System in 300 long bone non-unions[J]. Injury, 2014, 45(Suppl 6): S93-S97. DOI:10.1016/j.injury.2014.10.030
周英勇, 程少文, 安涛, 等.经皮自体骨髓移植治疗胫骨骨折延迟愈合及不愈合的临床研究[J].医学研究杂志, 2016, 45(3):22-25. DOI:10.11969/j.issn.1673-548X.2016.03.007
Zhou Y Y, Cheng S W, An T, et al. Clinical study of delayed union and nonunion of tibial fracture treated by percutaneous autogenous bone marrow transplantation[J]. Journal of Medical Research, 2016, 45(3): 22-25.
陈孝平, 汪建平.外科学[M].北京:人民卫生出版社, 2013: 635.
Chen X P, Wang J P. Surgery[M]. Beijing: People's Medical Publishing House, 2013: 635.
Connolly J F, Guse R, Tiedeman J, et al. Autologous marrow injection as a substitute for operative grafting of tibial nonunions[J]. Clin Orthop Relat Res, 1991(266): 259-270. DOI:10.1097/00003086-199105000-00038
Braly H L, O'Connor D P, Brinker M R. Percutaneous autologous bone marrow injection in the treatment of distal meta-diaphyseal tibial nonunions and delayed unions[J]. J Orthop Trauma, 2013, 27(9): 527-533. DOI:10.1097/BOT.0b013e31828bf077
Sugaya H, Mishima H, Aoto K, et al. Percutaneous autologous concentrated bone marrow grafting in the treatment for nonunion[J]. Eur J Orthop Surg Traumatol, 2014, 24(5): 671-678. DOI:10.1007/s00590-013-1369-9
王玉龙, 王明贵, 贺小兵, 等.自体骨髓干细胞移植治疗胫骨骨折骨不连[J].局解手术学杂志, 2014, 23(2): 131-134. DOI:10.11659/jjssx.1672-5042.201402009
Wang Y L, Wang M G, He X B, et al. Autologous bone-marrow stem-cell transplantation for nonunion of tibia fracture[J]. Journal of Regional Anatomy and Operative Surgery, 2014, 23(2): 131-134. DOI:10.11659/jjssx.1672-5042.201402009
Ollivier M, Gay A M, Cerlier A, et al. Can we achieve bone healing using the diamond concept without bone grafting for recalcitrant tibial nonunions[J]. Injury, 2015, 46(7): 1383-1388. DOI:10.1016/j.injury.2015.03.036
Hankenson K D, Zimmerman G, Marcucio R. Biological perspectives of delayed fracture healing[J]. Injury, 2014, 45(Suppl 2): S8-S15. DOI:10.1016/j.injury.2014.04.003
Tan S L, Ahmad T S, Selvaratnam L, et al. Isolation, characterization and the multi-lineage differentiation potential of rabbit bone marrow-derived mesenchymal stem cells[J]. J Anat, 2013, 222(4): 437-450. DOI:10.1111/joa.12032
Gross J B, Diligent J, Bensoussan D, et al. Percutaneous autologous bone marrow injection for treatment of delayed and non-union of long bone: a retrospective study of 45 cases[J]. Biomed Mater Eng, 2015, 25(1 Suppl): 187-197. DOI:10.3233/BME-141235
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