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 controled study. A total of 42 patients with limb comminuted fracture and bone defects were enroled 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 cancelous bone. In the control group, 22 patients underwent plate, screw or intramedulary 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.
ABSTRACT
[Objective]To examine the safety and efficacy of closing-opening wedege osteotomy for angular kyphosis.Seven patients with angular kyphotic deformity of the thoracic or thoracolumbar spine were treated by closing-opening wedge osteotomy using a single posterior approach.[Method]Seven patients with angular kyphosis were treated.The apex level of kyphosiswas T5 in one patient,T11 in one,and T12 in five.There was old fracture in five patients,congenital deformity in one,and neurofibromatosis in one.The first 30?~35? of kyphosis were corrected using the closing wedge technique with the hinge of the anterior longitudinal ligament after veretebrectomy and circumspinal decompression of the spinal cord.Then the hinge was moved posteriorly to the spinal cord and the remainder of the requisit angle of osteotomy was corrected using the opening-wedge technique(closing-opening wedge osteotomy).Spinal curvature was stabilized using posterior instrumentation and graft.[Result]Localized kyphosis was reduced from and average of 67? to 18? at 2.2 to 7.5 years ' follow-up.Sagittal alignment from T1 to the sacrum became more physiologic than before.There were no neurologic complications.Bony fusion was achieved in all patients,and there was no correction loss.[Conclusion]Satisfactory correction is safely performed by closing-opening wedged osteotomy with a direct visuzlization of the circumferentiall decompressed spinal cord.Although the performance is technically laborious,it offers good correction without jeopardizing the integrity of the spinal cord.