不同植骨材料配合LCP治疗尺桡骨骨折不愈合的疗效研究

摘要

Objective:To compare the effectiveness of locking compression plate combined with three different bone grafts autogenous bone, allogeneic bone,and bone morphogenetic protein (BMP) composite bone for radius and ulna fracture nonunion.Method:From December 2009 to December 2013, 62 cases of eligible of radius and ulna fracture nonunion were randomly treated with autogenous bone (group A, n=22), allogeneic bone (group B, n=23), and BMP composite bone (group C, n=17).The cure rate after 12 months and the Anderson good rate of forearm fractures were compared among 3 groups at different time points.Result:All patients of 3 groups were followed up at least 12 months. The cure rate of groups A and B was signifcantly different ( χ2=5.494,P < 0.05), but no significant diference was found between groups A,C and B,C (P>0.05).The Anderson good rate was compared at same period:There were significant difference between the group A and B of each time period (P<0.05),but no significant difference was found between groups A and C; at 6th and 12th months after operation, there was significant difference between the group B and C (P<0.05).Conclusion:The effect of BMP composite bone is equivalent to that of autogenous bone graft in treating nonunion of radius and ulna fracture, and they are better than allogeneic bone graft.%目的：比较自体骨、同种异体骨、BMP复合骨配合LCP治疗尺桡骨骨折不愈合的临床疗效。方法：选取2009年12月-2013年12月采用植骨配合LCP治疗尺桡骨骨折不愈合的62例患者，根据植骨材料不同分为自体骨组（A组，22例）、同种异体骨组（B组，23例）、BMP复合人工骨组（C组，17例）。比较不同时间点三组Anderson前臂骨折功能优良率及12个月后的治愈率。结果：A、B两组骨不连治愈情况比较差异有统计学意义（χ2=5.494，P<0.05）。A、C及B、C组间比较骨不连治愈比较差异无统计学意义（P>0.05）。A、B两组各时间段优良率比较差异均有统计学意义（P<0.05）；而A、C组比较差异均无统计学意义（P>0.05）；9个月与12个月时，B、C组比较差异有统计学意义（P<0.05）。结论：BMP复合骨在配合LCP治疗尺桡骨骨折不愈合中与自体骨基本等效，并优于同种异体骨。