Percutaneous autologous bone marrow injection in the treatment of delayed union of long bone fractures after definitive fixation

Abstract

The purpose of this study was to assess the results of percutaneous autologous bone marrow injection in the treatment of delayed union of long bone fractures after definitive fixation. It has been a gruelling job for the orthopaedic surgeons to deal with the delayed union after definitive fixation due to the lack of patient compliance for reoperation like classical bone grafting technique for delayed union and non-union, unfavourable fracture site morphology for external compression, post-operative surgical wound issues etc., The percutaneous autologous bone marrow injection is a reasonable choice in this scenario for the treatment of Delayed union of long bone fractures after definitive fixation. The study was performed in the department of orthopaedics Assam Medical College and Hospital, Dibrugarh, Assam, India for a period of 2 years from July 2019 to June 2021. A total of 23 patients were taken with delayed union of long bone fractures after definitive fixation. These 23 patients were treated with percutaneous autologous bone marrow injection and followed up for 6 months. The results were evaluated on the basis of clinico-radiological criteria of union, and found to be excellent in 60.86% (14/23), good in 17.39% (4/23) and poor in 21.73% (5/23) cases. The percutaneous autologous bone marrow injection provides cellular stimulation and promotes fracture healing without the necessity for opening the fracture site. Hence it is an effective method to bring about successful outcome of delayed union of long bone fractures after definitive fixation without adding any significant complication to the patient and the fracture site.