Curative Effect of Minimally Decortication Combined with Autologous Bone Marrow Injection in the Treatment of Bone Non-union After Locking Plate Internal Fixation of Tibial Shaft Fracture
YANG Xiaolong
FAN Kejun
LU Huan
QIAO Shaolin
SHAO Chen
LIAN Wenwen
Abstract：Objective To observe the clinical effect of minimally decortication combined with local injection of au-tologous bone marrow in the treatment of bone nonunion after locking plate internal fixation of tibial shaft fracture.Methods The clinical data of 61 patients with bone nonunion after locking plate internal fixation of tibial shaft fracture from January 2015 to June 2022 were retrospectively analyzed.The patients were divided into the observation group(n=31)and the control group(n=30)according to the odd even number method.The patients in observation group were trea-ted with minimally decortication combined with local injection of autologous bone marrow.and the patients in control group were treated with open exposed fracture end removal of sclerotic bone,reanalization of pulp cavity combined with autogenous iliac bone grafting.Perioperative indexes,postoperative visual analogue scale(VAS)scores,postoperative complications and modified Olerud-Molander ankle scoring system scores 12 months after surgery of patients between the two groups were compared.Results The operative time,intraoperative amount of bleeding,postoperative hospital stay,postoperative full weight bearing time and fracture healing time in observation group were significantly less than those in control group(all P＜0.05).The results of single effect analysis showed that,the VAS score of the observation group was significantly lower than that of the control group 1 day after surgery and 1 month after surgery(all P＜0.05);the VAS scores of the two groups showed a decreasing trend with the extension of time from 1 day to 6 months after surgery(all P＜0.05).At 12 months after surgery,the modified Olerud-Molander ankle fracture scores of joint stiffness,swelling(calf),climbing stairs,running,j umping,squatting,daily activities at work and total scores in the observation group were significantly better than those in the control group(all P＜0.05),and the distinguished achiever ratio of observation group in the modified Olerud-Molander ankle fracture scores was significantly higher than that in the control group(P＜0.05).The total incidence of postoperative complications in the observation group was sig-nificantly lower than that in the control group(P＜0.05).Conclusion The minimally decortication combined with local injection of autologous bone marrow in the treatment of tibial shaft fracture after locking plate internal fixation is a reliable and effective treatment with short operation time,less trauma and fewer postoperative complications.
Keywords：Tibial shaft fractureDecorticationAutologous bone marrow injectionLocking plate internal fixa-tionBone nonunion
Publication Date：2025-01-27
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 31-36 )