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肱骨干骨折延迟愈合:富血小板血浆处理自体骨移植与未处理自体骨移植的比较:一项随机、单盲临床试验

Delayed union of humeral shaft fractures: comparison of autograft with and without platelet-rich plasma treatment: a randomized, single blinded clinical trial.

作者信息

Acosta-Olivo Carlos, Garza-Borjon Abiel, Simental-Mendia Mario, Vilchez-Cavazos Felix, Tamez-Mata Yadira, Peña-Martinez Victor

机构信息

Departamento de Ortopedia y Traumatología, Hospital Universitario "Dr. José E. Gonzalez", Universidad Autonoma de Nuevo Leon, Ave Madero y Gonzalitos s/n. Mitras Centro, 4to piso, CP: 64480, Monterrey, Mexico.

出版信息

Arch Orthop Trauma Surg. 2017 Sep;137(9):1247-1252. doi: 10.1007/s00402-017-2736-5. Epub 2017 Jun 30.

Abstract

INTRODUCTION

Despite an adequate orthopedic treatment with functional bracing, some patients develop a delayed union in humeral shaft fractures. The objective of the present study was to determine the bone consolidation time among patients with delayed union of diaphyseal humeral fractures who were managed with locking compression plate (LCP) fixation combined with an iliac crest autograft using platelet-rich plasma (PRP) as a co-adjuvant.

MATERIALS AND METHODS

This study was a controlled, randomized, experimental, longitudinal, comparative, prospective, blind clinical trial. Patients diagnosed with delayed union of a diaphyseal humeral fracture with at least 4 months of evolution were treated with an open reduction and LCP osteosynthesis combined with an iliac crest autograft. The experimental group also received PRP. The patients were assessed radiographically until 36 weeks of evolution.

RESULTS

A total of 16 patients were included. Both groups had similar demographic characteristics. The patients treated with PRP had an earlier beginning of bone consolidation. Furthermore, these same patients exhibited bone consolidation at 19.9 weeks, on average, in contrast to 25.4 weeks in the control group.

CONCLUSIONS

The use of PRP promotes earlier bone consolidation in patients with delayed union of the humeral shaft.

摘要

引言

尽管采用功能性支具进行了充分的骨科治疗,但仍有一些患者出现肱骨干骨折延迟愈合。本研究的目的是确定采用锁定加压钢板(LCP)固定联合自体髂嵴骨移植并使用富血小板血浆(PRP)作为辅助治疗的肱骨干骨折延迟愈合患者的骨愈合时间。

材料与方法

本研究为对照、随机、实验、纵向、比较、前瞻性、盲法临床试验。诊断为肱骨干骨折延迟愈合且病程至少4个月的患者接受切开复位和LCP接骨术联合自体髂嵴骨移植治疗。试验组还接受了PRP治疗。对患者进行影像学评估直至病程36周。

结果

共纳入16例患者。两组患者的人口统计学特征相似。接受PRP治疗的患者骨愈合开始时间更早。此外,这些患者平均在19.9周时实现骨愈合,而对照组为25.4周。

结论

使用PRP可促进肱骨干延迟愈合患者更早实现骨愈合。

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