Ashok Goel, , a, S. S. Sangwanb, R. C. Siwachb and Ahmad M. Alic
a University Hospital Aintree, 33 Irene Road, Liverpool L16 8 NS, UK b Department of Orthopaedic and Traumatology, Medical College and Hospital, Rohtak, India c Oldchurch Hospital, Waterloo Road, Romford, Essex RM7 0BE, UK
Abstract This is a prospective study to evaluate the efficacy of percutanous bone marrow grafting in patients with established tibial non-union and minimal deformity, whilst on the waiting list for open surgical procedures. Twenty consecutive patients with established tibial non-union and minimal deformity were treated by percutanous bone marrow injection under local anaesthesia. Bone marrow was obtained from the iliac crest, 35 ml of marrow was aspirated and injected immediately into and about the non-union site. Subsequent aspirations were performed 1 cm posterior to the previous site until a maximum of 15 ml of marrow was injected. Our results revealed clinical and radiological bone union following percutanous injection in 15 out of 20 patients (75%), with an average time to union following the first injection of 14 weeks. Four patients (20%) showed no evidence of union and were considered a failure. There were no cases of infection following the injection, and no complications at the donor site. We conclude that percutanous bone marrow grafting is a safe, simple, and reliable method of treating tibial non-union with minimal deformity. It is a limited invasive technique with minimal complications. It can be performed under local anaesthesia, is cost effective and potentially can avoid major surgical reconstruction.
Injury Volume 36, Issue 1 , January 2005, Pages 203-206.