Long-term clinical observation on treatment of delayed union and nonunion of long bone fractures by using decalcification bone matrix / 中华创伤杂志

ABSTRACT

Objective To explore remote effect of decalcification bone matrix (DBM) in treatment of delayed union and nonunion of long bone fractures. Methods From 1986, 96 cases of delayed union and nonunion of long bone fractures were treated with DBM. Of all, 38 cases of nonunion of long bone were treated with surgical implantation, 37 delayed union and 21 nonunion with percutaneous injection. Results All 96 cases were followed up for 4-16 years (average 7.5 years). Of 37 cases of delayed union treated with percutaneous injection, 35 attained bone union but 2 resulted in nonunion of tibial fractures with a union rate of 94.6%. Of 21 cases of bone nonunion treated with percutaneous injection, 17 got bone union but 4 did nonunion (3 tibial nonunion and 1 humeral nonunion) with a union rate of 80.1% and union time for 3-8 months (average 4.5 months). Of 38 cases treated with implantation of DBM, 36 had bone union but 2 nonunion at 1/3 inferior to the tibia with a union rate of 94.7%. Conclusions Either percutaneous injection or surgical implantation of DBM can attain satisfactory effect even to autograft. After prepared by dehydration, degrease, decalcification and irradiation disinfection, DBM is characterized by safer transplantation and less immunity than other bone transplantations and can be preserved for a long time so as to be applied both in the peacetime and the wartime.