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富血小板血浆注射治疗萎缩性骨折不愈合

[Platelet-rich plasma injection for the treatment of atrophic fracture nonunion].

作者信息

Wang Lin, Yang Jian-Ye, Zhang Bing-Wen, Qi Zhi-Qiang, Song Jun-Sheng

机构信息

The First Department of Orthopaedics, Luan Group General Hospital, Changzhi 046000, Shanxi, China.

出版信息

Zhongguo Gu Shang. 2020 Mar 25;33(3):261-4. doi: 10.12200/j.issn.1003-0034.2020.03.015.

Abstract

OBJECTIVE

To explore clinical effects of platelet rich plasma (PRP) injection in treating atrophic fracture nonunion.

METHODS

From March 2015 to March 2017, 15 patients with atrophic fracture nonunion were treated with PRP injection, including 10 males and 5 females, aged from 23 to 56 years old with an average age of (40.0±9.1) years old, the time of fracture nonunion ranged from 6 to 14 months with an average of (8.87±2.45) months. Preparing PRP by extracting 60 to 100 ml peripheral blood. PRP platelet count ranged from 587 to 1 246 with an average of (947.13±158.58) ×10 9 /L. Under the perspective, 13 to 20 ml PRP were injected into the fracture end, and each injection was performed once on the first and the second week of the treatment. Complications such as whether the limb was shortened, angulation, and rotational deformity and radiological examination were observed.

RESULTS

All patients were followed up from 6 to 12 months with an average of (6.8± 2.1) months. No shortening, angulation, and rotational deformity occurred. Thirteen patients had fracture healing, the time ranged from 4 to 6 months with an average of (4.8±0.7) months. Two patients had no completely porosis at 12 months during following up, and 1 patient occurred bolt loose. Other patients had no complications.

CONCLUSION

The stability of fracture ends of atrophic fracture nonunion after internal fixation is an indication for local PRP injection. PRP treatment for atrophic fractures could completed under local anesthesia, and it has advantages of safe operation and reliable efficacy.

摘要

目的

探讨富血小板血浆(PRP)注射治疗萎缩性骨折不愈合的临床效果。

方法

选取2015年3月至2017年3月收治的15例萎缩性骨折不愈合患者,其中男10例,女5例;年龄23~56岁,平均(40.0±9.1)岁;骨折不愈合时间6~14个月,平均(8.87±2.45)个月。抽取外周血60~100 ml制备PRP,PRP血小板计数为587~1 246,平均(947.13±158.58)×10⁹/L。在透视下向骨折端注射PRP 13~20 ml,于治疗第1、2周各注射1次。观察肢体有无短缩、成角、旋转畸形等并发症及影像学检查情况。

结果

所有患者均获随访,随访时间6~12个月,平均(6.8±2.1)个月。均未出现短缩、成角及旋转畸形。13例患者骨折愈合,愈合时间4~6个月,平均(4.8±0.7)个月。2例患者随访至12个月时未完全愈合,1例患者出现螺钉松动。其余患者未出现并发症。

结论

萎缩性骨折不愈合内固定后骨折端的稳定性是局部注射PRP的适应证。PRP治疗萎缩性骨折可在局部麻醉下完成,具有操作安全、疗效可靠的优点。

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