Study of percutaneous autologous bone marrow injections in delayed and nonunion of long bone fractures: A prospective study

Abstract

Introduction: The potential benefit of human mesenchymal stem cells has received increasing attention in a wide variety of biomedical fields. The management of delayed union and non-union poses as a challenge to many orthopaedic surgeons. Bone marrow contains osteoprogenitor cells capable of forming bone. Aims and Objectives: To observe the functional outcome, evaluate complications and assess the factors influencing results of bone marrow injection in long bone fractures which are in delayed union and non-union. Methodology: We conducted prospective follow up study in orthopaedic department at tertiary care hospital over a period of two years. 30 patients with delayed or non-union of long bone fractures were included in the study About 20-50 ml of bone marrow was aspirated from single or both posterior iliac crests and injected into the recipient site under radiological control. Clinically patients were assessed and cortical bridging on AP and lateral X-rays was noted. Results: In our study sex, age, state of union, initial treatment given before BMA, site of fracture, type of fracture, amount of bone marrow aspirate etc did not have any significant association with the final outcome after bone marrow injection. Also we did not get any significant complications. Conclusion: Bone marrow injection from iliac crest (posterior) is safe, effective treatment method for delayed and non-union of long bone fractures without any significant complications.