经皮X射线下自体骨髓间充质干细胞与血浆垂直注射大腿骨折点1例：7个月随访疗效评价

为评价自体骨髓间充质干细胞结合血浆移植治疗骨不连的临床疗效，选择2000-03因左大腿车祸伤后行走疼痛男性患者1例，X射线片检查显示左股骨干骨折且骨缺损距离为5 mm，诊断为骨折。经一系列固定复位治疗及髓内钉固定和自体髂骨植骨2次和外固定架与自体髂骨植骨4次治疗后，骨折仍未愈合，于2008-03入住四平市中心医院接受经皮自体骨髓间充质干细胞结合血浆移植治疗。在小C型臂X射线透视下，从骨折点大腿皮肤的前面，用硬膜外穿刺针垂直注射辅以10%患者自体血浆的骨髓间充质干细胞悬液4 mL，细胞浓度为1.8×107 L-1。以门诊复查方式进行X线检查，观察骨折愈合情况。X射线片显示，移植后2个月，骨折间隙缩小，左股骨干骨痂连续，骨折线部分模糊；移植后4个月，左股骨干骨折线模糊，骨痂连续；移植后7个月左股骨干在实现骨性愈合，患者开始完全负重行走，功能良好，完全治愈，无发热、感染等不良反应发生。提示经皮自体骨髓干细胞移植治疗股骨骨不连是一种安全有效的方法。

Percutaneous radiological autologous bone-marrow mesenchymal stem cells grafting integrating with blood plasma by injection in the part of thigh fracture: Seven-month follow-up effect evaluation in one case

To evaluate the clinical therapeutic effect of the autologous bone marrow mesenchymal stem cells grafting integrating blood plasma transplantation in treatment of problematic nonunion. In March 2000, a 29-year-old man presented complaints of painful walking of left thigh after a velocity injury, was selected. Radiography revealed a left femoral shaft fracture, and the bone defect distance was 5 mm through X-ray examination before operation. Following a series of reposition, fixation, intramedullary nail fixation and twice autogenous iliac bone graft treatment, external fixator and autogenous iliac bone graft treatment, totally four times, the fracture was not healed. He come to Orthopaedic Surgery Department of Siping Central Hospital to accept the autologous bone marrow mesenchymal stem cells grafting integrating blood plasma transplantation in March 2008. Under the small C-arm X-ray perspective, 4 mL bone marrow-derived mesenchymal stem cells suspension integrating 10% autologous blood plasma was injected vertically into fracture site from the skin in front of the thigh with epidural needle, and the stem cells density was 1.8 × 107 cells/L. X-ray examination was performed though out-patient recheck to observe fracture healing. Two months after graft, radiography results showed fracture interspace reduced, left femoral shaft callus was continual and fracture lines blurred partly of the left femur; furthermore, left femoral shaft fracture lines blurred, and continuous bone callus formation of the left femur at 4 months after graft; The left femur achieved bone union within 7 months. The patient was returned to full weight bearing walking and good function with a fully healed femoral bone, without any fever or infection. Percutaneous transplantation of autologous bone marrow stem cells for treatment of problematic nonunion has the satisfactory result.