Analysis of the three therapy methods in treatment of refractory bone nonunion

[Objective] To analyze the clinical application and effect of three therapy methods in treatment of refractory bone nonunion.[Method] From April 2003 to February 2008,a total of 36 patients (39 limbs) suffered from refractory bone nonunion were studied,there were 22 males and 14 females with an average age of 51.5 years (range,15～71 years).The nonunion occurred in 19 tibia,9 humeri,7 femora,and 4 radius or ulnae.The nonunion experienced operation for 1 to 4 times (average,2.5 times).The fracture gaps were 4.5～36 mm (average,16.5 mm)according to X-rays measurement before operation.The shortened length of lower limb was 5-40 mm (average,21 mm).Nineteen limbs were cured with the autologous bone marrow integrating artificial bone and ilium periosteum transplantation (combination group),9 limbs were cured with the autologous bone marrow and artificial bone (marrow group),11 limbs were cured with autologous ilium transplantation (ilium group).[Result] All 39 limbs got bone union,36 patients were followed up for 12 to 28 months (average,18.5 months).The combination group obtained excellent results on bone healing time,limb function score and postoperation X-ray score( P 0.05).The bone healing time was 5.5±1.5 months in combination group,6.6±1.8 months in marrow group and 7.4±2.1 months in ilium group.[Conclusion] Autologous bone marrow integrating artificial bone and ilium periosteum transplantation for the refractory nonunion,can achieve satisfactory results.