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題名 | Efficacy of Autologous Percutaneous Bone Marrow Graft Injection for Treatment of Nonunion of the Tibia=經皮自體骨髓注射治療於脛骨骨折未癒合 |
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作者 | 簡建龍; 唐秀蘭; 王世杰; 張志鴻; 林松俊; 陳志如; 楊啟人; 陳泰昌; 李心白; 李建和; 侯勝茂; | 書刊名 | 臺灣外科醫學會雜誌 |
卷期 | 34:6 民90.11-12 |
頁次 | 頁294-301 |
分類號 | 416.26 |
關鍵詞 | 經皮自體骨髓注射; 脛骨骨折未癒合; Bone graft; Fracture; Nonunion; Bone marrow; |
語文 | 英文(English) |
英文摘要 | Traditional autologous bone grafting for nonunion is associated with many complications in both donor and recipient sites.This retrospective study investigated the efficacy of autologousp percutaneous bone marrow graft injection for treatment of nonunion of the tibia in a series of patients.Fourteen adult patients with fractures of the tibia with nonunion were treated with autologous percutaneous bone marrow graft injection at our hospital from January 1996 to January 2000.There were ten male patients and four female patients.The average age of the patients was 26.5 years (range,2I to 62 years).The duration of follow up averaged l year 8 months and ranged from l2 months to 4 years.The indications for the procedure was the presence of an established traumatic tibial nonunion. The nonunion was classified as hypertrophic in two patients and atrophic in l2 patients.The mean duration from injury to marrow injection was l year!]range, 12 to 26 months).The mean duration from the last operation to bone marrow injection was l0.4 months!]range,7 to l6 months).The mean size of the bony defect was 6.5 mm (range,3.0 to 36 mm).The mean time from injection of bone marrow to union of the fracture was 6 months (range,3 to 10 months).Patients received marrow injected in volumes of 80 to 100 mL obtained using multiple punctures l to 2 cm apart along the iliac crest.The mean number of nucleated type cells in the aspirated marrow was 3.6x104/mm3(range,2.9 to 5.2x104/mm3).Four patients received repeated in jections.Clinical and radiological union and recovery of pre-injury activity level was achieved in I2 of l4 cases (85.7%),and there were two cases with initial infected nonunion which failed to achieve union.Conclusions:The results of this study suggest that autologous percutaneous bone marrow graft injection is a simple, effective,and safe operative treatment for nonunion of the tibia.Tibial nonunion with an active infection is a contraindication for this procedure. |
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