title: Percutaneous bone marrow grafting for the treatment of tibial non-union.
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, 3-5 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.
authors.affiliation: University Hospital Aintree, 33 Irene Road, Liverpool L16 8 NS, UK. agoel33@yahoo.com
authors.forename: Ashok
authors.initials: A
authors.lastname: Goel
authors.forename: S S
authors.initials: SS
authors.lastname: Sangwan
authors.forename: R C
authors.initials: RC
authors.lastname: Siwach
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Ali
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D005260:Female; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D017211:Treatment Failure; D016896:Treatment Outcome