Abstract

Percutaneous bone marrow injection is a simpler method of performing autologous bone grafting with less morbidity than standard technique. Autologous bone grafting has been a standard operative method used for the treatment of delayed union and non-union for decades but has been associated with numerous complications. In recent times, percutaneous bone marrow grafting has emerged as a successful alternative to traditional method of open bone grafting. The medical records and radiographs of 50 patients of delayed and non-union were analysed between 2007 to 2010 in our institution. Among those, 38 cases were of delayed union and 12 of non-union involving different bones of the body, with tibia as the most common site (54%). 39 cases were males and 11 females. Mode of injury was road traffic accident in 70% of the cases. Duration of injury was 20 to 24 weeks in 22% of cases followed by 24 to 28 weeks in 18% of cases. Among 50 cases, local anaesthetic was used in 39 cases. Only one injection was given in 30 cases (60%) and two injections in 20 cases (40%). 73.3% cases of delayed union required only one injection and out of 12 cases of non-union, 10 cases (83.3%) required two injections. The cases were evaluated radiologically after a variable period of time for callus formation. Mean time taken for union in successful cases was 14.6 weeks in delayed union and 18.4 weeks in non-union. Out of 50 cases, union was achieved in 46 cases. Union rate was more in case of delayed union (97.37%). In case of non-union, percutaneous bone marrow injection was successful in only 75% of the cases. We concluded that percutaneous autologous bone marrow grafting has been most useful for preventive treatment of non-union by early injection in delayed union, with less complications and morbidity. The general idea is that the minimally invasive technique of percutaneous bone marrow grafting is worth exploring before embarking on a more extensive open surgery.

Key words: Percutaneous bone marrow grafting, delayed union, non-union, injection