A long-term Clinical Observation on Delayed Union and Nonunion of Long Bone Fractures Treated with Decalcified Bone Matrix

Objective To investigate the long-term effect of decalcified bone matrix （DBM） in the treatment of delayed union and nonunion of long bone fractures. Methods From 1986 to 1994, 96 patients with delayed union or nonunion of long bone fractures were treated with DBM. Among them, 38 patients with nonunion were treated with surgical implantation of DBM, 37 with delayed union and 21 with nonunion were treated with percutaneous iniection of DBM. Results All 96 cases were followed up for 4 to 16 years （mean time, 7.5 years）. Of 37 patients with delayed union treated with percutaneous injection, 35 achieved bone union, but 2 with tibial fractures did not. and the union proportion was 94.6%. Of 21 patients with nonunion treated with percutaneous injection, 17 achieved bone union, but 4 （3 with tibial and I with humeral fractures） did not, and the union proportion was 80.1%. The time needed for union was 3 to 8 months （mean, 4.5 months）. Of 38 patients with nonunion treated with implantation of DBM, 36 had bone union, but 2 with fractures in the infcrior 1/3 of the tibia did not, and the union proportion was 94.7%. Conclusion Both percutaneous injection and surgical implantation of DBM can achieve satisfactory therapeutic effects that are even as good as that of autografting. Meanwhile, after dehydration, degreasing, decalcification and irradiation sterilization, DBM is safer and less immunogenic than other bone grafts and can be preserved for a long time so as to be applied both in peacetime and in wartime.

A long-term Clinical Observation on Delayed Union and Nonunion of Long Bone Fractures Treated with Decalcified Bone Matrix