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王林* wanglin 潞安集团总医院 lu’an?group?hospital 
杨建业 yangjianye 山西省长治市潞安集团总医院  
张秉文 zhangbingwen 山西省长治市潞安集团总医院  
祁志强 qizhiqiang 山西省长治市潞安集团总医院  
宋俊生 songjunsheng 山西省长治市潞安集团总医院  
中文摘要:[摘要] 目的 探讨PRP注射治疗萎缩性骨折不愈合的疗效,适应症。方法 自2015年3月至2017年3月采用PRP注射治疗15例萎缩性骨折不愈合患者,男10例,女5例,年龄23-56岁,平均年龄40.0±9.1岁,病程6-14个月,平均(8.87±2.45)个月。抽取外周血60-100ml,制备PRP,PRP血小板计数:587-1246×109/L,平均947.13±158.58×109/L。透视定位下于骨折断端注射PRP13-20毫升,分别于治疗起始的第1周和第二周各注射1次。每月复查1次,通过是否有术后并发症、患肢是否有短缩、成角、旋转畸形等临床检查和影像学检查进行评估。结果 全部病例均获得随访,随访时间6-12个月,平均6.8±2.1个月。与治疗前相比,本组患者患肢均无短缩、成角、旋转畸形,13例患者骨折愈合,骨愈合时间4~6个月,平均4.8±0.7个月;2例患者12个月随访时完全无骨痂形形成,其中1例治疗期间螺钉松动,其余病例均无并发症。结论 萎缩性骨折不愈合内固定术后骨折断端稳定是局部PRP注射的适应症。PRP治疗萎缩性骨折不愈合局麻穿刺下即可完成,操作安全、疗效可靠。
【关键词】PRP;骨折不愈合  骨折
PRP injection for the treatment of atrophic fracture nonunion
ABSTRACT  [Abstract] Objective To investigate the efficacy and indications of PRP injection in the treatment of atrophic fracture nonunion. Methods From March 2015 to March 2017, 15 patients with atrophic fracture nonunion were treated with PRP injection. There were 10 males and 5 females, aged 23-56 years, with an average age of 40.0±9.1 years and a course of 6-14 months, average (8.87 ± 2.45) months. 60-100 ml peripheral blood was extracted to prepare PRP. The PRP platelet count was 587-1246×109/L, with an average of 947.13±158.58×109/L. Under the perspective, 13 to 20 ml of PRP was injected into the fracture end, and each injection was performed once in the first week and the second week of the treatment. It was reviewed once a month and evaluated by clinical examination and imaging examinations such as postoperative complications, whether the limb was shortened, angulation, and rotational deformity. Results All cases were followed up for 6-12 months with an average of 6.8±2.1 months. Compared with before treatment, the patients in this group had no shortening, angulation, and rotational deformity. 13 patients had fracture healing. The bone healing time was 4-6 months, with an average of 4.8±0.7 months. Two patients were 12 months. At the time of follow-up, there was no bone formation, and one of the screws was loose during treatment, and the other cases had no complications. Conclusion Atrophic fractures do not heal, and the stability of fracture ends after internal fixation is an indication for local PRP injection. PRP treatment of atrophic fractures can be completed under local anesthesia, safe operation and reliable efficacy.
KEY WORDS  PRP  fracture nonunion  fracture
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