富血小板血浆联合同种异体骨治疗非感染性骨不连的临床应用

目的:评价富血小板血浆联合同种异体骨治疗非感染性骨不连的临床疗效。方法:回顾性分析我院创伤骨科2010年2月-2015年1月的非感染性骨不连患者,比较同种异体骨加富血小板血浆混合物与自体髂骨植骨治疗非感染性骨不连的疗效。结果:两组共随访非感染性骨不连患者69例,全部进行了术中断端植骨,其中富血小板血浆联合同种异体骨植骨组(PRP组)21例,其中愈合19例,未愈合2例,临床愈合率90.5%。自体髂骨植骨组(自体骨组)48例,愈合44例,4例未愈合,临床愈合率91.6%。PRP组平均手术持续时间为(108.73±13.91),自体骨组为(120.54±13.87)min,两组间有统计学意义(P0.05)。术后3月,PRP组患者X线骨痂评价标准平均评分值为(2.54±0.43)分,自体骨组为(2.62±0.45)分,两组间差异无统计学意义(P0.05)。结论:富血小板血浆混合同种异体骨植骨治疗骨不连较传统自体髂骨植骨可缩短手术时间,避免供骨区并发症,修复效果良好,为骨不连的治疗提供了一个新的方法。

Clinical Application of Platelet-Rich Plasma (PRP) and Artificial Bone Complex in Treatment of Bone Non-union

Objective:To evaluate the clinical therapeutic effects of platelet rich plasma (PRP) combined allogeneic bone grafting in the treatment of noninfectious bone nonunion.Methods:Cases of noninfectious bone nonunion were collected from the patients received by the Department of Traumatic Orthopedics since February 2010 to January 2015. The therapeutic effects between PRP combined allogeneic bone grafting and autogenous iliac bone grafting were compared by retrospective study.Results:Total of 69 cases were collected and all of the 69 patients received the treatment of bone grafting in the fracture area. Among the 21 cases in PRP group, 19 cases were healed, while the other 2 cases remained nonunion. The cure rate was 90.5 %. 44 of the 48 patients received autogenous bone grafting had complete bone union, besides of 4 cases remaining nonunion. The cure rate was 91.6%. The average duration of surgery was (108.73± 13.91) min in PRP group and (120.54± 13.87) min in autogenous bone group. The difference had statistical significance (P<0. 05). Reviewed 3 mouth later, the standard average X-ray score of bone callus was (2.54± 0.43) points in PRP group compared with (2.62± 0.45) points in autogenous bone group. The difference had no statistical significance (P>0.05).Conclusion:PRP combined allogeneic bone graft shortened the operation time, with the avoidance of the complication in the bone-supply area. There were no significant differences of the therapeutic effects between two groups, demonstrating the PRP combined allogeneic bone grafting would be a new method to cure bone nonunion.