Abstract
Background: Non-union fractures, particularly in patients experiencing soft-tissue loss, comorbidities, and chronic infection, can be difficult to treat. These fractures are typically accompanied by high rates of post-surgical non-union and recurrence of infection. The Ilizarov method has addressed conditions such as infection, deformity, soft-tissue loss, and joint contracture. However, techniques to optimize the osteogeneic potential of inured bone are relatively new. Autologous concentrated bone marrow aspirate (cBMA) and Platelet Rich Plasma (PRP) are therapies that increase osteogeneic potential of osteoconductive demineralized bone matrix (DBM).
Highlights
Serious orthopedic injuries such as non-unions and bimalleolar and pilon fractures, can be treated successfully with the Ilizarov method [1]
One of the two patients who failed to heal with the first treatment received an additional concentrated bone marrow aspirate (cBMA) treatment and healed
We conclude that the Ilizarov method combined with demineralized bone matrix (DBM), cBMA and Platelet Rich Plasma (PRP) is a safe, reliable, and effective method with good clinical outcomes for the treatment of non-union fractures in patients with significant co-morbidities
Summary
Serious orthopedic injuries such as non-unions and bimalleolar and pilon fractures, can be treated successfully with the Ilizarov method [1]. The classic Illizarov technique has several advantages when treating patients with various comorbidities [4] With this technique, the reduction and fixation of the fracture is performed with minimal soft-tissue exposure and blood loss and the fixation is stable enough to allow weight bearing soon after surgery. Non-union fractures, in patients experiencing soft-tissue loss, comorbidities, and chronic infection, can be difficult to treat. These fractures are typically accompanied by high rates of post-surgical non-union and recurrence of infection. Purpose: To evaluate the efficacy of the Ilizarov method combined with a cocktail of demineralized bone matrix (DBM), concentrated cBMA and PRP in promoting healing of bone Autologous concentrated bone marrow aspirate (cBMA) and Platelet Rich Plasma (PRP) are therapies that increase osteogeneic potential of osteoconductive demineralized bone matrix (DBM).
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