13.Outcome of Autogenous Bone Marrow Injection in Tibial Fractures with Signs of Delayed Union
Shahid Rahman1, Aman ul Haq2, Inayat ur Rehman1, Israr Ahmed1, Muhammad Bilal1 and Kifayat Ullah1
ABSTRACT
Objective: To determine the outcome of autogenous bone marrow injection in tibial fractures with signs of delayed union in terms of clinical and radiological evidence of union.
Study Design: Descriptive randomized prospective study
Place and Duration of Study: This study was conducted at the Department of Orthopedic Surgery, LRH, Peshawar for a period of 6 months from January, 2020 to July, 2020.
Materials and Methods: Patients admitted with delayed union of tibial shaft fractures were included in the study. Under local anesthesia, bone marrow is aspirated from the anterior iliac crest using a special bone marrow aspiration needle into heparinized syringes to avoid clotting of the aspirate. The bone marrow is aspirated from multiple sites to minimize dilution of the aspirate with blood. Under fluoroscopy control, the aspirate is injected percutaneously into and around the fracture site.
Results: Total 38 patients include with delayed union of tibial fractures. 32 (84.2%) males & 06 (15.8%) females. In 22 (57.9%) patients mid-shaft of tibia was involved followed by distal tibia in 9(23.7%) patients and proximal tibia was involved in 7(18.4%) patients. 25(65.8%) patients were smokers while 13(34.21%) patients were nonsmokers. In 22 (57.5%) patients right side of limb was involved while in 16 (42.5%) left side of limb was involved. In 18 (47.5%) patients there is only 1 follow up followed by 2 follow ups in 11(28.9%) and 3 follow ups in 9(23.7%) patients. In 30 patients (78.94%), union was established after 3 months of follow-up and at the end of six months follow-up in 6(15.78%) patients. In delayed union of tibial fractures, the union rate was 94.73%.
Conclusion: Percutaneous autogenous bone marrow injection is a slightly invasive, safe, & inexpensive treatment option for tibial delayed unions and should be considered when the retained hardware seems to be intact & stable.
Key Words: Delayed union, Bone marrow, long bones, fracture healing, tibial shaft fractures
Citation of article: Rahman S, Aman ul haq, Inayat ur rehman, Ahmed I, Bilal M, Kifayat Ullah. Outcome of Autogenous Bone Marrow Injection in Tibial Fractures with