RESUMO
Objective: to determine the outcome of bone marrow injection in fractures with signs of delayed union and nonunion in terms of clinical and radiological evidence of union
Study design: descriptive case series
Place and Duration of study: department of Orthopedics and Spinal Surgery, Ghurki Trust Teaching Hospital Lahore, from October 2014 to May 2015
Methodology: patients admitted with nonunion or delayed union were included in the study. After evaluation and taking informed consent bone marrow was taken from the iliac crest with the help of bone marrow biopsy needle and injected at the site of fracture with the aid of lumbar puncture [LP] needle under image guidance. Repeat injection was given at three month interval, if needed. Clinical and radiological evidence of bone healing was assessed at six weekly follow ups till six months
Results: a total of 80 patients were included. There were 48 males and 32 females. There were 42 tibial, 18 femoral, 11 radius/ulna and 9 humeral fractures. Sixty-two procedures under local anesthesia and eighteen under short sedation were performed. In 67 patients union occurred following injection. The mean healing time was 16 weeks
Conclusion: percutaneous bone marrow injection is an alternative treatment of choice for delayed union and nonunion for long bone fractures