title: Autologous marrow injection as a substitute for operative grafting of tibial nonunions.
abstract: Autologous marrow injection was used to stimulate healing in 20 ununited tibial fractures over a five-year period. The technique was employed in conjunction with cast immobilization in ten cases and intramedullary nail fixation in ten cases. Marrow stimulated a callus formation sufficient to unite eight of the ten nonunions immobilized with casts and all ten of the fractures immobilized by intramedullary nails. Bone-marrow injection was as effective as past open autologous grafting but with considerably fewer disadvantages. The technique provides a promptly renewable and reliable source of osteogenic stem cells with numerous advantages compared with standard open-grafting techniques.
authors.affiliation: Department of Orthopaedic Surgery, Creighton-Nebraska Health Foundation, University of Nebraska.
authors.forename: J F
authors.initials: JF
authors.lastname: Connolly
authors.forename: R
authors.initials: R
authors.lastname: Guse
authors.forename: J
authors.initials: J
authors.lastname: Tiedeman
authors.forename: R
authors.initials: R
authors.lastname: Dehne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016026:Bone Marrow Transplantation / Q000379:methods*; D002370:Casts, Surgical; D005594:Fracture Fixation, Intramedullary; D005597:Fractures, Open / Q000628:therapy; D005599:Fractures, Ununited / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D014182:Transplantation, Autologous; D014945:Wound Healing