目的探讨经皮自体骨髓移植治疗骨折不愈合的疗效.方法治疗患者31例,男 25例,女6例;年龄18－77岁,平均27岁.骨不连部位:防骨7例,腕舟骨12例,股骨5例,胫骨7例.骨不连时间7－48个月,平均13个月.治疗方法:在X线电视透视下将一枚骨穿针准确穿入骨不连部位,然后抽取自体骼骨红骨髓即刻注入骨不连部位.腕舟骨注射 10－ 15 ML,一次即可;四肢长骨注射 30－50 ML,需 2－ 3次,间隔 3－4周.患肢选用合适的固定.结果骨折愈合 26例,愈合时间 5－ 9个月,平均7个月.其中12例腕舟骨骨不连全部愈合,5例长骨的骨不连未愈合,无感染等并发症发生.结论经皮自体骨髓移植在骨不连部位有成骨作用,对不具备切开植骨条件的长骨骨不连及腕舟骨骨不连病例,可选用经皮自体骨髓移植方法治疗.“,”Objective To investigate the effect of autogenous hone marrow grafting in the management of nonunion of fractures. Methods Thirty-one patients were treated for nonunion of fractures. There were 7 of the humerus, 12 the carpal scaphoid, 5 the femur and 7 the tibia. The average age of the patients was 27 years (range 18 -- 77 years). The average time from nonunion to percutaneous bone marrow grafting was 13 months (range 7 -- 48 months). The operation was performed under local or general anesthesia. A marrow needle was inserted into the site of the nonunion under the X -- ray, and a total of 10 -- 50 ml of bone marrow was aspirated from the anterior or posterior iliac crest and was injected immediately into the site of nonunion, the limb was then immobilized. During the operation, a total of 10 -- 15 ml of hone marrow was injected into the carpal scaphoid only once, while a total of 30 -- 50 ml of hone marrow was injected into the long bones, and the procedure was repeated after 3 -- 4 weeks. Results Twenty-six of the 31 fractures had union in 7 (5 -- 9) months. All of the 12 carpal scaphoid were healed. Failure occurred in 5 cases, and there was no other complication in this group. Conclusion Percutaneous autogenous bone marrow grafting can play a role in osteogenesis at the site of nonunion. It is a method of choice for the treatment of nonunions of the carpal scaphoid and those fracture nonunions with poor local conditions contraindicated to open surgery.