Percutaneous Autologous Bone Marrow Injection In The Treatment Of Delayed And Non-Union Of Long Bones
Percutaneous Autologous Bone Marrow Injection
DOI:
https://doi.org/10.70284/njirm.v4i2.2145Keywords:
Bone marrow injection, Delayed union, Non union, Long bonesAbstract
Hospital Surat, *** Asst Prof , Department of Physiology, **** J/S (ORTHO) ,GMERS Med College, Gotri, Vadodara-390021 Abstract: Context: Bone marrow has been shown to contain osteo-progenitor cells. Percutaneous autologous bone marrow injection (PABMI) encourages early treatment of delayed union and non-union to expedite healing and minimize complications from prolong immobilization. Aims and objectives: To assess the outcome of PABMI treatment in delayed and non-union of long bones. Study design: Prospective study Participants and procedures: 24 cases (33 bones) of Delayed and non-union of long bones were selected. Percutaneous autologous bone marrow injection treatment was adopted for fracture healing. Change in pattern of union was followed after 12 weeks by clinical and radiological study. Results: 90% of tibial fractures, 66.66% of radial fractures and 50% of ulna fractures show clinical and radiological union. 100% of the fractures with no gap at the fracture site united, where the gap was less than 1 cm, 85% of bone united, in only 1 case the gap was more than 1 cm and it failed to unite. 7 out of 9 bones in hypertrophic non-union united, whereas 4 out of 6 bones in atrophic non-union united. Conclusion: Percutaneous autologous bone marrow grafting is an effective and safe method for the treatment of diaphyseal non union. We strongly believe that an injectable preparation that combines marrow with osteoinductive and osteoconductive agents should virtually eliminate the need for open harvesting and operative grafting of the problems associated with fracture healing.
References
2. Sim R, Liang TS, Tay BK. Autologous marrow injection in the treatment of Delayed and nonunion in long bones. Singapore Med J 1993; 34(5): 412-7.
3. Ph.hernigu MD, G Mathian, A Poignard. Percutanous autologous bone marrow grafting for non union-influence of number & concentrate of progenitor cells. JBJS 2005; 87(7): 1430-1437.
4. Ph.hernigu MD, G Mathian, A Poignard. Percutanous autologous bone marrow grafting for non union-surgical technique JBJS 2006; 88: 322-327.
5. Timour F, EI-Husseini. Percutaneous bone marrow autotransplantation in the treatment of delayed and non union of long bones. Department of orthopedic surgery, Ain Shams University, Cairo. 1997.
6. Healey JH, Zimmerman PA, McDonnell JM and Lane JM. Percutaneous bone marrow grafting of delayed union and non union in cancer patients. Clinical Orthopedics and related research 1990; 25(6): 280-285.
7. Autologous bone marrow injection for delayed union of tibia: A preliminary report: J. Orthop trauma 1989; 3: 276-382
8. Phemister DB. Treatment of un-united fracture by only bone graft without a screw or tie fixation and without breaking down of the fibrous union. JBJS 1947; 29:1946-1947.
9. Connolly JF. Common avoidable problem in non-union. Clin. Orthop 1985; 19(4): 226.
10. Connolly JF. Injectable bone marrow preparations to stimulate osteogenic repair. Clinical orthopaedics and related research 1995; 313: 8-18.