经皮骨膜下注射成骨细胞治疗骨折延迟愈合与骨不连26例

26例患者中骨折延迟愈合14例，骨不连12例，均行骨膜下及骨折间隙注射成骨细胞治疗。从患者自身髂后上棘抽取骨髓组织，经体外诱导、培养、扩增为成骨细胞，按无菌操作术在X射线定位下于骨折延迟愈合或骨不连病变部位骨膜下及骨折间隙注射浓度为1×105 cells/mL的成骨细胞5~8 mL，注射后4，6，10，14周定期摄X射线片观察病变部位骨痂生长情况。所有病例随访3~12个月，平均5.3个月。复查X射线片见4周有骨痂形成，6周骨痂包绕骨折断端，10周骨折线模糊，14周骨折线消失。所有患者骨折均愈合，平均愈合时间为12.1周。提示经皮骨膜下注射成骨细胞治疗骨折延迟愈合与骨不连是一种有效的修复方法。

Percutaneous subperiosteum injection of osteoblasts for the treatment of delayed fracture healing and bone nonunion An analysis of 26 cases

A total of 26 patients comprising 14 with delayed fracture healing and 12 with bone nonunion were treated via subperiosteum and fractured spatial injection of osteoblasts. Bone marrow was extracted from posterior superior iliac spine to obtain osteoblasts following in vitro induction, culture and amplification. Subsequently, 5-8 mL osteoblasts at a density of 1 × 105 cells/mL was sterilely injected into subperiosteum and fractured interspace in injured region using X-ray positioning. At 4, 6, 10 and 14 weeks after injection, callus formation was checked using X-ray. All cases followed up for 3-12 months, with the means of 5.3 months. Callus was formed after 4 weeks, fractured ends were wrapped up by callus after 6 weeks, and fracture line was unclear after 10 weeks and disappeared after 14 weeks. Bone fracture was healed, with the mean healing time of 12.1 weeks, suggesting that percutaneous subperiosteum injection of osteoblasts is an effective method to treat delayed fracture healing and bone nonunion.