OBJECTIVETo observe the clinical therapeutic effect of treatment for long bone fracture nonunion in limbs by bone morphogenetic protein compounds combined with autologous red bone marrow graft.

METHODSFrom January 2004 to December 2010,36 cases of long bone fracture nonunion in limbs were treated by bone morphogenetic protein compounds combined with autologous red bone marrow graft. There were 22 males and 14 females with an average age of 36.8 years old ranging from 22 to 68 years. Nonunion sites included humerus in 6 cases,ulna in 4 cases,radius in 3 cases,femur in 10 cases,and tibia in 13 cases. The latest reconstruction was performed on these 36 cases during 8 to 24 months (means 13.7 months) after injuries. There were 22 cases of hypertrophic nonunion,14 cases of atrophic nonunion. Main clinical symptoms were pain of fracture sites on weight bearing: and swelling of limbs. Clearness of fracture line and bone defect were indicated on X-ray. The therapeutic effect of the treatment after operation was been evaluated by wound healing, reaction in the area of bone graft and bone marrow aspiration,fracture healing,and recovery of adjacent joint function.

RESULTSAll incisions primarily healed,immunologic rejection and anaphylaxis were not detected in these incisions. Infection and haematoma formation were not detected in the area of bone marrow aspiration. All these 36 cases were followed up for 3 to 20 months (means 16.2 months). Chronic pain in the area of bone marrow aspiration, bone infection in the area of bone graft, and red swelling of the skin near incisions or sinus tract were not detected. Bony union was achieved in all cases in 3 to 12 months (means 6.2 months) after operation, malunion was not detected. Pain of fracture sites on weight bearing and swelling of limbs disappeared after bony union. The adjacent joint function completely recovered in most cases,only 5 cases remained some function limited part.

CONCLUSIONIn the treatment of long bone fracture nonunion in limbs, bone morphogenetic protein compounds combined with autologous red bone marrow graft have the advantage of wide range of sources, safety and promoting bone union,which is one of the ideal bone graft