BMC musculoskeletal disorders · 2026 · 統合分析（依標題推測）

Efficacy and safety of biological agents and physical therapies for delayed union or nonunion of fractures: a network meta-analysis of randomized controlled trials.

全身性肌肉骨骼・風濕・疼痛 · 骨折延遲癒合／不癒合

中文閱讀摘要

針對骨折癒合不良，網路統合分析顯示BMA加ACB癒合率較高且不良事件風險低，LIPUS可縮短癒合時間，但證據品質低。

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原始摘要

Background

Delayed and nonunion fractures remain a significant clinical challenge in orthopedics. This study compared the effects of biologics and physical therapies for delayed or nonunion fractures.

Methods

We comprehensively searched and included randomized controlled trials (RCTs) investigating biologics and physical therapies for delayed or nonunion fractures; the outcomes included healing rate, healing time and adverse events. We ranked the interventions' therapeutic efficacy through data analysis.

Results

Twenty-seven RCTs (involving 1495 patients and 15 interventions) were included. For fracture healing rate, bone marrow aspirate (BMA) combined with autologous cancellous bone (ACB) exhibited significantly better efficacy than ACB alone (OR = 8.14, 95% CI: 1.69 to 39.32). SUCRA ranking revealed that BMA + ACB (96%), platelet-rich plasma (PRP) + ACB (77.3%) and bone morphogenetic protein (BMP) + ACB (70.5%) ranked among the top three interventions for fracture healing rate. For fracture healing time, LIPUS (SMD = -9.33, 95% CI: -12.94 to -5.73) and PRP + ACB (SMD = -2.43, 95% CI: -4.14 to -0.72) both significantly reduced the fracture healing time relative to ACB. For adverse events, BMA + ACB (OR = 0.12, 95% CI: 0.03 to 0.59) and BMP (OR = 0.15, 95% CI: 0.04 to 0.61) had the lowest risk of adverse events relative to ACB alone.

Conclusion

Preliminary evidence suggests that among currently available biologics and physical therapies, BMA combined with ACB may be associated with a higher fracture healing rate. LIPUS may help shorten the healing time in patients with mild delayed and nonunion fractures, while BMA combined with ACB potentially exhibits the lowest risk of adverse events. However, the quality of current evidence is low, and these findings require further validation through large-scale RCTs.

至 Europe PMC 閱讀完整來源 ↗ · 擷取日期 2026-10-19

書目、來源與全文狀態

DOI: 10.1186/s12891-026-09973-w
PMID／PMCID: 42210142 / PMC13422364
作者: Wang Y, Zhuang W, Lei B, Zhang D, Ma S, Wang H, Han Q
首次發表日期: 2026-05-28Europe PMC 提供，部分日期可能依年份或月份推定。
卷／期／頁碼或文章編號: 27 ／ 1 ／ 637
書目來源與查核日期: Europe PMC · 2026-10-19僅核對書目欄位與來源連結；不代表已評讀研究品質。
全文與授權: 來源列有免費全文（查核 2026-10-19），未逐篇測試 PDF 下載。來源授權標示：cc by。

可回溯引用

Wang Y, Zhuang W, Lei B, Zhang D, Ma S, Wang H, Han Q. Efficacy and safety of biological agents and physical therapies for delayed union or nonunion of fractures: a network meta-analysis of randomized controlled trials. BMC musculoskeletal disorders. 2026;27(1):637. PMID: 42210142. PMCID: PMC13422364. doi:10.1186/s12891-026-09973-w

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