CAJ | 학술논문

目的：：分析经皮自体骨髓移植治疗前臂新鲜骨折伴骨缺损患者的临床效果。方法：随机选取11例前臂新鲜骨折伴骨缺损因局部皮损感染不能一期手术植骨内固定的患者为研究组,经伤口清创、骨折复位、石膏或外固定架固定、抗生素抗感染治疗无明显感染症状后,于3、6、9周采用透视下经皮自体骨髓移植方法治疗骨折缺损；随机选取12例前臂新鲜骨折伴骨缺损患者为对照组,给予植骨内固定治疗。两组患者均以6、9、12、24周X线复查结果评估骨折愈合情况。结果：研究组10例患者骨折24周后完全愈合,1例患者骨缺损明显减少,骨折线清晰,断端硬化,未完全愈合；对照组12例患者24周骨折均顺利愈合。结论：对于前臂新鲜骨折伴骨缺损的患者,植骨内固定术是可靠治疗方法；对于部分开放骨折伴缺损不能一期植骨内固定治疗的患者,经皮自体骨髓移植于骨折骨缺损处,能促进骨折愈合,修复骨缺损,可取得与早期植骨内固定术相似的一期愈合的效果,避免二次植骨手术。
목적：：분석경피자체골수이식치료전비신선골절반골결손환자적림상효과。방법：수궤선취11례전비신선골절반골결손인국부피손감염불능일기수술식골내고정적환자위연구조,경상구청창、골절복위、석고혹외고정가고정、항생소항감염치료무명현감염증상후,우3、6、9주채용투시하경피자체골수이식방법치료골절결손；수궤선취12례전비신선골절반골결손환자위대조조,급여식골내고정치료。량조환자균이6、9、12、24주X선복사결과평고골절유합정황。결과：연구조10례환자골절24주후완전유합,1례환자골결손명현감소,골절선청석,단단경화,미완전유합；대조조12례환자24주골절균순리유합。결론：대우전비신선골절반골결손적환자,식골내고정술시가고치료방법；대우부분개방골절반결손불능일기식골내고정치료적환자,경피자체골수이식우골절골결손처,능촉진골절유합,수복골결손,가취득여조기식골내고정술상사적일기유합적효과,피면이차식골수술。
Objective:To analyze clinical effects of percutaneous autologous bone marrow transplantation in treatment of fresh forearm fracture with bone defect. Methods:11 patients, who suffered from fresh forearm fracture with bone defect and could not get I Phase operation of bone graft fixation because of local skin infection, were randomly selected as experimental group. After debride-ment, reduction, plaster or external fixator fixation, and no obvious symptoms of infection after a antibiotics treatment, the percutane-ous autologous bone marrow transplantation therapy was used for fracture defect using the X-ray at the 3rd, 6th and 9th week. 12 pat-ines with forearm fresh fractures combined with bone defect were chosen as control group, and given internal fixation treatment. The fracture healing at 6th, 9th, 12th, and 24th weeks under X-ray was reviewed regularly. Results: For experimental group, 10 cases with fracture were healed completely 24 weeks after the treatment;and the bone defect in 1 case was decreased significantly, fracture line was clear, and broken end was hardened and not completely healed. For control group, 12 cases were all healed smoothly 24 weeks after the treatment. Conclusions:To the patients with forearm fresh fractures and bone defect, bone graft and internal fixation is a reliable treatment. For the patients with part open fracture and defect who can't get the I phase bone graft fixation treatment, percuta-neous autologous bone marrow transplantation in fracture and bone defect can promote the fracture healing, repair of bone defect, obtain the similar primary healing effect of early bone graft and internal fixation, and avoid the secondary bone graft surgery.