Matsuda Y, Sakayama K, Okumura H, Kawatani Y, Mashima N, Shibata T
Department of Orthopaedic Surgery, School of Medicine, Ehime University, Japan.
Nihon Geka Hokan. 1998 Mar 1;67(1):10-7.
Percutaneous bone marrow injections were performed on 7 nonunions of the femur. There were 6 hypervascular nonunions and one avascular nonunion. Two nonunions presented with active infections. One other patient had a history of infection which had subsided. One nonunion received the injection twice. After the site of nonunion was curetted and the bone surface was scored, 150 ml of bone marrow aspirated from the iliac bone was injected. Complete union occurred in 4 patients within 9 months; all of them were uninfected hypervascular nonunions following intramedullary nail fixation. One nonunion with a bone defect united partially leaving a 1 x 1 cm defect. The two infected femoral nonunions failed to unite. The results show that percutaneous autologous bone marrow injection for femoral nonunions can be considered for uninfected hypervascular nonunions following intramedullary nail fixation. In these cases stimulation of healing processes of fracture leading to consolidation can be expected from bone marrow injection. However, femoral nonunion with an active infection and loss of fixation is considered to be a contraindication for this technique.
对7例股骨骨不连患者进行了经皮骨髓注射。其中有6例为高血运性骨不连，1例为缺血性骨不连。2例骨不连伴有活动感染。另有1例患者有已消退的感染病史。1例骨不连接受了两次注射。在刮除骨不连部位并对骨表面进行刻痕处理后，注入从髂骨抽取的150毫升骨髓。4例患者在9个月内实现了完全愈合；他们均为髓内钉固定后未感染的高血运性骨不连。1例伴有骨缺损的骨不连部分愈合，遗留1×1厘米的缺损。2例感染性股骨骨不连未愈合。结果表明，对于髓内钉固定后未感染的高血运性股骨骨不连，可考虑行经皮自体骨髓注射。在这些病例中，骨髓注射有望刺激骨折愈合过程从而实现骨愈合。然而，伴有活动感染和内固定失效的股骨骨不连被认为是该技术的禁忌证。
