Clinical analysis of percutaneous autologous bone marrow transplantation to heal malunion of fracture induced by infections in 19 cases

Zhigang KONG; Haiquan YU; Wenzhao XING

ABSTRACT

BACKGROUND:

Autologous bone marrow transplantation (ABMT) has been widely used in treatment of the malunion of fracture, but this treatment to cure malunion of fracture induced by infection is still not consistent.

OBJECTIVE:

To observe the application and clinical outcome of ABUT for the malunion of fracture induced by infection.DESIGN, TIME AND

SETTING:

A retrospective analysis. The patients were all enrolled at Department of Orthopaedics in the Third Affiliated Hospital of Hebei Medical University from January 2001 to January 2006.

PARTICIPANTS:

A total of 19 patients with malunion of fracture induced by infection, including 13 males and 6 females aged from 18 to 50 years, with an average of 36. The lesioned site contained fracture of tibia 10, fracture of femur 5, fracture of ulna 2 and fracture of humerus 2. Among them, there were 6 cases with bone defect, 9 cases with bone fracture delayed union and 4 cases with bone fracture disunion.

METHODS:

Nineteen patients treated with percutaneous ABUT. Among the 19 cases, 12 patients received the transplant 3 weeks after infection was under controlled, and other 8 patients received the transplant following autologous bone transplantation.MAIN OUTCOME

MEASURES:

After ABMT, all patients were checked using X-ray regularly, the pacing of bone union was traced through observing the growth of callus, and the side reaction was also detected.

RESULTS:

Totally 19 patients were included in the follow-up visit, and 15 cases of them achieved bony union. Clinical healing time was 7-20 weeks. The patients had no obvious discomforts except local gas pains when injecting and at pristine time after injection. Five patients had a small quantity of exudation. No infection relapse or soft tissue ossification were observed at the injection position. Four patients had not achieved bony union, the reason was that bone defect in 2 patients exceed 2 cm; fracture disunion with pseudoarticulation formatted in one patient, the sclerous broken ends of fractured bone was more than 2 cm; another patient's external fixation displaced, we adjusted it and the bone healed after 12 weeks. Three patients received autoallergic ilium bone transplantation in the second time of operation, the fractured bone got bony union.

CONCLUSION:

ABMT by percutaneous injection into malunion site can induce ossification, repair bone fracture and bone defects. The clinical application is simple and exhibits small wounds without complications. Especially ABMT is effective for the patient with the malunion of fracture induced by infection.