A preliminary study on minimally invasive treatment of nonunion in long bone shaft using percutaneous injectable artificial bone

GUO Zhiyong; BAI Bo; DONG Weiqiang; GUO Jing

doi:10.3969/j.issn.1674-666X.2015.03.002

Abstract：Objective To investigate the clinical effects of percutaneous minimally invasive treatment of nonunion in long bone shaft using injectable artificial bone. Methods Thirty-six patients with long bone shaft nonunion treated in the First Affiliated Hospital of Guangzhou Medical University from January 2011 to June 2014 were included, which was randomly divided into observation group ( percutaneous injectable artificial bone <br> graft, n = 18) and control group (autogenous iliac bone graft, n = 18). The differences of the operation time, intraoperative estimate blood loss, length of hospital stay, visual analogue scale (VAS) score, bone healing rate, and Johner-Wruhs therapeutic effect rating results were compared between two groups. Results All patients were followed up for 6 to 18 months (average, 10.6 months). The operation time, intraoperative estimate blood loss, length of hospital stay and VAS score 1 d after the operation in observation group and control group were (38 ± 10) and (89 ± 14) min, (6 ± 3) and (34 ± 12) mL, (5 ± 3) and (13 ± 3) d, 2.3 ± 1.4 and 5.6 ± 1.8 respectively, these indicators in observation group were better than those in control group (P <0.05). According to the Johner-Wruhs standard, there were excellent in 16 cases and good in 2 cases in observation group, with bony healing in all patients; While in control group, there were excellent in 13 cases, good in 3 and poor in 2, bony healing was obtained in 16 patients, the other 2 patients who were poor conditions needed to perform another open bone grafting. There was no statistical difference of excellent and good rate between two groups (P >0.05). Conclusion Percutaneous minimally invasive treatment of long bone shaft nonunion using injectable artificial bone has the advantages of short operation time, less injury, quick recovery and good pain symptom improvement.