Abstract: Introduction: Fracture healing is a form of wound healing that involves bone regeneration and leads to the restoration of skeletal integrity. Despite recent developments fracture stabilisation and understanding of biological healing processes, delayed union remains a challenging clinical condition. Bone marrow being abundant in osteoprogenitor cells is being tried to enhance the fracture healing. This study emphasizes the proficiency of bone marrow injected at the fracture site with delayed union and to reduce the time of morbidity for patients who are at the risk of development of non-union.
Aim: To study the union rates and complications of percutaneous bone marrow injection at the site of delayed union of long bone fractures.
Materials and Methods: This is a prospective observational study at BLDEU'S Shri B. M. Patil Medical College, Hospital and Research Centre, Department of Orthopaedics between November 2020 TO March 2022.
Patients who were admitted with delayed union of long bone fracture and were assessed clinically and radiologically at 6 weeks,3 months, 6 months & 9 months.
In this research 35 patients had percutaneous bone marrow injection who were in delayed union based on clinical assessment and radiographs depending on extent of the initial displacement, communition, soft tissue loss, postoperative reduction, and alignment.
Such instances were chosen for bone marrow injection when they failed to demonstrate the anticipated clinical and radiological union level within a predetermined time frame. The iliac crest or tibial tuberosity was used as the site for the bone marrow aspiration.
This Bone marrow injection was given into the fracture site under fluoroscopic guidance, distance between the fractured segments and signs of callus formation were assessed. The data obtained will be entered into a Microsoft Excel sheet, and statistical analysis will be performed using a statistical package for the social sciences (Version 20). Results are presented as Mean (Median) ±SD, counts and percentages and with p value of 0.05.
Results: Amongst 35 patients, 28(80%) showed complete bony union, another 4(11.4%) indicated progressive healing, and 3(8.5%) showed non union. This simple, effective method shortens the amount of time that morbidity develops as a result of delayed union and allows faster bony union Complications like surgical site infections and anaesthetic complications were not encountered. Postoperative pain was managed with adequate analgesia with NSAIDS.
As a result, it is concluded that effective union can be achieved in delayed union of long bones with percutaneous autologous bone marrow injection, without any complications at donor or recipient site. Bone marrow injection is a safe and secure method to treat delayed union of long bone fractures.
