Application Of Bone Graft Material Containing RhBMP-2combine With Allogeneic Bone Graft In Nonunion After Femoral Intramedullary Nailing

Objective: To investigate the clinical efficacy of bone grafts containing recombinant human bone morphogenetic protein 2(Bone Conduction)treating of nonunion of femoral fracture after intramedullary nailing.Methods: The clinical data of 41 patients with nonunion of femoral fracture after intramedullary nailing from August 2008 to August 2016 in Department of Orthopedics of Affiliated Renhe Hospital of China Three Gorges University,Yuan’an People’s Hospital and Zigui People’s Hospital were analyzed retrospectively.They were divided into Bone Conduction Group and Autogenous Bone Group according to different bone grafting methods.Bone Conduction Group was treated with Bone Conduction combined with allograft bone grafting.Autogenous Bone Group was treated with autogenous bone grafting.The autogenous bone was taken from the ipsilateral ilium.The two groups were compared operative time,intraoperative blood loss,postoperative wound drainage,postoperative wound complications,hospitalization time,postoperative visual analog scale,mean image healing time,the score for Schatzker-Lambert and Johner-Wruhs after the operation.SPSS19.0 statistical software was used to analyze the data.Measurement data were expressed as((?)±S).The independent sample t test was adopted in measurement data and the counting data was tested by Chi-squared test.Results: In the Bone Conduction Group,operative time was(118.2±25.6)minutes,intraoperative blood loss was(315.4±52.8)ml,postoperative wound drainage(42.5±13.6)ml,hospitalization time was(5±2)days,postoperative visual analog scale was(5±2)days.But in the Autogenous Bone Group,operative time was(149.5±21.3)minutes,intraoperative blood loss was(367.2±56.4)ml,postoperative wound drainage(85.3±15.2)ml,hospitalization time was(13±2)days,postoperative visual analog scale was(8±2)days.There were significant differences between the 2 groups,P<0.05.In the Bone Conduction Group,postoperative wound complications was 0 case,postoperative fever was 3 persons,Mean image healing time was(5.9±1.5)months.In the Autogenous Bone Group,postoperative wound complications was 2 case,postoperative fever was 3 persons,Mean image healing time was(6.1±1.4)months,These were not significant differences between the 2 groups,P>0.05.In the score for Schatzker-Lambert 9 months after the operation of the Bone Conduction Group,the excellent was 16 persons,the good was 2persons,the tolerable was 1 person,the off-grade was nobody,the excellent and good rate was 94.7%.In the score for Schatzker-Lambert 9 months after the operation of the Autogenous Bone Group,the excellent was 17 persons,the good was 4 person,the tolerable was 1 person,the off-grade was nobody,the excellent and good rate was 95.5%,these were not significant differences between the 2 groups,P>0.05.In the score for Johner-Wruhs 9 months after the operation of the Bone Conduction Group,the excellent was 17 persons,the good was 1 person,the tolerable was 1 person,the off-grade was nobody,the excellent and good rate was 94.7%.In the score for Johner-Wruhs 9 months after the operation of the Autogenous Bone Group,the excellent was 16 persons,the good was 4 person,the tolerable was 2 person,the off-grade was nobody,the excellent and good rate was 90.9%,these were not significant differences between the 2 groups,P>0.05.Conclusion: Bone graft material containing recombinant human bone morphogenetic protein 2 has the advantages of simple operation,less trauma,less complications,high osteogenic activity and good bone graft effect is an effective method to treat nonunion of femoral fracture after intramedullary nail.