Autologous platelet-rich plasma and autologous bone graft for comminuted fractures: randomized controlled follow-up

doi:10.3969/j.issn.2095-4344.2014.22.027

Abstract

Abstract:

BACKGROUND: Studies showed that platelet-rich plasma + bone transplantation for repair of bone defects not only can accelerate new bone formation, but also increase bone density.

OBJECTIVE: To observe autologous platelet-rich plasma and autologous bone graft for treatment of comminuted fractures, and the efficacy.

METHODS: This was a clinical prospective randomized controlled study. A total of 42 patients with limb comminuted fracture and bone defects were enrolled and randomly assigned to two groups. In the experimental group, 20 patients received treatment with autologous platelet-rich plasma and mixture of autologous ilium and cancellous bone. In the control group, 22 patients underwent plate, screw or intramedullary nail fixation. At 1, 3, 6 and 12 months after surgery, X-ray examination was conducted. Healing conditions, healing speed and functional recovery were compared between the experimental and control groups.

RESULTS AND CONCLUSION: The time of bone healing was respectively 12 weeks in the experimental group and 18 weeks in the control group on average, showing significant differences. There were two cases of plate breakage, one case of nonunion reoperation, three cases of delayed fracture healing in the control group. No autologous blood transfusion or other complications appeared in the experimental group. Results suggested that autologous platelet-rich plasma and autologous bone graft for comminuted fractures can facilitate and accelerate bone healing.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: platelet-rich plasma, fractures, bone, bone transplantation

CLC Number:

R318

Yue Yong, Paerhati•Rexiti, Wang Qiang, Lu Jie, Yilixiati•Alifu, Han Xue-ying, Xu Xiao-xiong, Adeli•Abudurexiti, Julaiti•Jilili, Li Jing-ting, Pan Jie, Zhao Li-ying, Sun Gai-sheng . Autologous platelet-rich plasma and autologous bone graft for comminuted fractures: randomized controlled follow-up[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(22): 3603-3608.

Figures/Tables 3

2.3 两组患者基线资料分析见表1。 2.4 两组患者治疗后骨折愈合结果两组患者治疗后一般情况均正常。拔除引流管后，切口均未见红、肿等炎性反应，均甲级愈合，12-14 d后拆线。经统计学分析，两组患者伤口引流量、伤口愈合天数、伤口反应程度、围术期并发症、住院天数等方面差异无显著性意义(表2)，而在骨折愈合时间上，实验组明显少于对照组。 2.5 影像学观察及其评分实验组：治疗后3个月，骨缺损区及其周围植骨处有少许新骨形成，密度增高骨痂影；治疗后6个月时，骨缺损区可见大量高密的骨痂影，绝大部分骨折线已模糊；12个月时，骨断端见大量骨痂，骨折线完全消失，骨缺损完全修复。对照组：治疗后3个月，骨折端外可见少量骨痂生长，但不及实验组，骨折处骨质密度均匀下降，大部分骨折线仍可见；治疗后6个月时，骨折断端及缺损区可见骨痂生长，但明显少于实验组，骨折线已模糊，有5例骨折线任较清晰，骨折处骨质明显骨质疏松，有2例钢板断裂(锁骨骨折、胫骨骨折)再次手术；治疗后10个月时，1例骨不连再次手术；治疗后12个月时，19例骨缺损完全修复。 2.6 两组患者治疗后功能观察结果实验组：因骨折愈合时间较短，与健侧相比，未见骨折处的上下关节功能障碍。对照组：1例股骨髁上骨折患者，膝关节屈伸仅有30°，3例胫骨骨折患者，膝关节屈伸仅有0-30°，0-50°之间，1 例桡骨骨折患者，腕关节屈伸较对侧减少有20°，1例肱骨骨折患者，肘关节屈伸较对侧减少有25°。 2.7 住院花费实验组因有取髂骨费用，多出1 000元；但是，对照组因骨折愈合时间延长，陪护照顾费用增加、病废时间延长，相应费用增加，远超出1 000元取髂骨的手术费。 2.8 并发症实验组未出现自体输血等并发症；对照组有3例行再次手术，其中2例为钢板断裂，1例为骨不连。 2.9 典型病例介绍患者男，25岁，行左侧胫腓骨骨折切开复位钢板内固定，治疗前后X射线片见图3。"

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