锁定钢板联合自体松质骨、BMP治疗小儿股骨干骨折术后不愈合的疗效:生物相容性研究

目的探讨锁定钢板联合自体松质骨,骨形态发生蛋白(BMP)治疗小儿股骨干骨折不愈合的临床疗效。方法 2012年1月-2016年6月我院共收治28例小儿股骨干骨折术后延迟愈合患者,其中16例采用锁定钢板联合同种异体骨植骨和BMP治疗,12例采用弹性髓内钉固定。观察两组术中出血量、手术时间、住院时间、住院费用和术后下地锻炼时间,术后随访1年,定期复查X线片,观察骨折愈合情况和内固定稳定性,统计并发症发生情况。结果术后所有病例均达到骨性愈合,X线发现内固定无松动。观察组平均愈合时间为3.89±0.28个月,对照组为3.82±0.25个月,两组差异无统计学意义(P0.05)。在随访期间均未出现骨折不愈或延迟愈合。两组均未出现感染、股骨头坏死、髋内翻畸形、低血压等并发症。两组术中出血量、住院时间、住院费用和术后下地锻炼时间无明显差异(P0.05);手术时间对照组长于观察组,其差异有统计学意义(P0.05)。结论锁定钢板联合自体松质骨,骨形态发生蛋白治疗小儿股骨干骨折不愈合疗效可靠,并发症少。

Efficacy of locking plate combined with autologous cancellous bone and BMP in treatment of postoperative nonunion of femoral shaft fractures in children

Objective To investigate the clinical effect of morphogenetic protein bone（BMP）in the treatment of femoral shaft fractures in children. Methods Twenty-eight cases of pediatric femoral shaft fractures were treated with cases of pediatric femoral shaft fractures from January 2012 to June 2016 in our hospital, and 16 cases were treated with locking plate and BMP, and 12 cases were treated with elastic intramedullary nailing. The amount of blood loss, operation time, hospitalization time, hospitalization expenses and postoperative exercise time were observed in the two groups. After 1 year follow-up, X-ray film was observed. Results all cases achieved bony union, and no loosening was found in X- ray findings. The average healing time of the observation group was 3.89±0.28 months, the control group was 3.82±0.25 months, the difference was not statistically significant（P>0.05）in the two groups. There was no fracture nonunion or delayed union in the follow- up period. There were no complications such as infection, necrosis of the femoral head, hip, and hypotension in the two groups. There was no significant difference in the amount of bleeding, hospitalization time, hospitalization expenses and postoperative exercise time in the two groups（P>0.05）；the control group was significantly different from the control group （P<0.05）. Conclusion The locking plate combined with autologous cancellous bone, bone morphogenetic protein in the treatment of femoral shaft fractures in children can improve the fracture healing rate, reliable fixation, less complications, and can be used in clinical application.