Morasiewicz Piotr, Zaborska Monika, Sobczak Michał, Tomczyk Łukasz, Pili Daniele, Kazubski Krystian, Leyko Paweł
Department of Orthopaedic and Trauma Surgery, Institute of Medical Sciences, University of Opole, Witosa 26, 45-401 Opole, Poland.
Institute of Medical Sciences, Faculty of Medicine, University of Opole, Witosa 26, 45-401 Opole, Poland.
J Clin Med. 2025 May 12;14(10):3353. doi: 10.3390/jcm14103353.
Patients with nonunion experience pain, mobility problems, and physical activity limitations; require long-term, costly treatment; and cannot resume work. Some authors recommend the use of pharmaceutical agents as an adjunct therapy in fracture and nonunion treatment. The aim of this study was to assess the effects of ossein-hydroxyapatite complex used as an adjunct therapy in nonunion treatment with the Ilizarov external fixator. In this retrospective study, we assessed 31 patients (nine women, 22 men) at a mean age of 47 years (29-68 years), who were receiving osteogenon, with aseptic tibial shaft nonunion treated with the Ilizarov external fixator in the period 2019-2023, designated as Group 1. The control group comprised 29 patients (five women, 24 men), at a mean age of 48 years, with aseptic tibial shaft nonunion treated with the Ilizarov external fixator, who did not receive osteogenon during treatment, designated as Group 2. We assessed the following parameters-duration of Ilizarov fixation, achieved bone union, time to resuming normal physical activity, maintained bone union, time to complete pain relief, the number of patients reporting complete pain relief, the number of patients who were fitted with a cast or splint following Ilizarov fixator removal, and the rate of complications. The median time to Ilizarov fixator removal was 275 days in Group 1 and 218 days in Group 2. In Group 1, bone union was observed in 100% of patients, in Group 2, 93% of patients achieved bone union. This difference was statistically significant, = 0.041. Maintained bone union was observed in 85.7% of patients from the osteogenon group and in 79.3% of patients from the control group, and the difference was not statistically significant. There were no differences between groups in the median time to resuming normal physical activity, the median time to achieving pain relief, the rate of complications, and the rate of pain relief. The use of ossein-hydroxyapatite complex has a beneficial effect on fracture nonunion treatment with the Ilizarov method. The use of osteogenon helps increase the proportion of patients with fracture nonunion who achieve bone union following treatment with the Ilizarov method. Osteogenon does not significantly affect complication rates, time to fixator removal, time to achieving pain relief, time to resuming normal physical activity, maintained bone union rates, or the proportion of patients who achieve pain relief.
骨不连患者会经历疼痛、活动问题以及身体活动受限；需要长期且昂贵的治疗；并且无法恢复工作。一些作者推荐将药物制剂作为骨折和骨不连治疗的辅助疗法。本研究的目的是评估骨胶原 - 羟基磷灰石复合物作为辅助疗法在使用伊里扎洛夫外固定器治疗骨不连中的效果。在这项回顾性研究中，我们评估了31例患者（9名女性，22名男性），平均年龄47岁（29 - 68岁），他们在2019 - 2023年期间接受骨生成素治疗，因无菌性胫骨干骨不连接受伊里扎洛夫外固定器治疗，被指定为第1组。对照组包括29例患者（5名女性，24名男性），平均年龄48岁，因无菌性胫骨干骨不连接受伊里扎洛夫外固定器治疗，治疗期间未接受骨生成素，被指定为第2组。我们评估了以下参数——伊里扎洛夫固定的持续时间、实现骨愈合、恢复正常身体活动的时间、维持骨愈合、完全缓解疼痛的时间、报告完全缓解疼痛的患者数量、伊里扎洛夫外固定器拆除后佩戴石膏或夹板的患者数量以及并发症发生率。第1组伊里扎洛夫外固定器拆除的中位时间为275天，第2组为218天。在第1组中，100%的患者观察到骨愈合，在第2组中，93%的患者实现了骨愈合。这种差异具有统计学意义，P = 0.041。骨生成素组85.7%的患者观察到维持骨愈合，对照组为79.3%，差异无统计学意义。两组在恢复正常身体活动的中位时间、实现疼痛缓解的中位时间、并发症发生率以及疼痛缓解率方面没有差异。骨胶原 - 羟基磷灰石复合物的使用对伊里扎洛夫方法治疗骨折不连有有益作用。骨生成素的使用有助于增加使用伊里扎洛夫方法治疗后实现骨愈合的骨折不连患者比例。骨生成素对并发症发生率、固定器拆除时间、实现疼痛缓解的时间、恢复正常身体活动的时间、维持骨愈合率或实现疼痛缓解的患者比例没有显著影响。
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