title: Role of injecting bone marrow aspiration injection in treating delayed union and non-union.
abstract: OBJECTIVE
  To access the role of bone marrow injection in the management of delayed union and non-union.
  
  
  METHODS
  The prospective study was conducted at the Department of Orthopaedic Surgery and Traumatology, Mayo Hospital, Lahore, from January 2012 to December 2013, and comprised patients who had long bone fractures that resulted in delayed or non-union and were treated with bone marrow injections. Aspiration of bone marrow was done from tibial tuberosity and was injected percutaneously at the fracture site. The whole procedure was carried out as a day case. Fracture site mobility, tenderness and radiological features were assessed using the Union Scale score.
  
  
  RESULTS
  Of the 25 patients, 18(72%)were male and 7(28%) were female with an overall mean age of 38±12.96SD years (range: 17-61 years). There were 19(76%) tibial shaft fractures, 4(16%) had shaft of femur fracture, and 2(8%) had humeral shaft fracture. Mean time duration between the injury and the procedure was 34 ±3.46 SD weeks (range: 30-42 weeks). Overall, 23 (92%) patients showed union and the mean time of healing was 15 ±2.73SD weeks (range: 12-22 weeks) after the procedure.
  
  
  CONCLUSIONS
  Percutaneous bone marrow injection provided an alternative to open bone grafting, having least complications, especially for early intervention in the fracture-healing process.
authors.affiliation: Department of Orthopedic Surgery and Traumatology Unit-1, Mayo Hospital, Lahore.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Akram
authors.affiliation: Department of Orthopedic Surgery and Traumatology Unit-1, Mayo Hospital, Lahore.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Irshad
authors.affiliation: Department of Orthopedic Surgery and Traumatology Unit-1, Mayo Hospital, Lahore.
authors.forename: Faheem Mubashir
authors.initials: FM
authors.lastname: Farooqi
authors.affiliation: Department of Orthopedic Surgery and Traumatology Unit-1, Mayo Hospital, Lahore.
authors.forename: Ranjeet Kumar
authors.initials: RK
authors.lastname: Sah
authors.affiliation: Department of Orthopedic Surgery and Traumatology Unit-1, Mayo Hospital, Lahore.
authors.forename: Muhammad Latif
authors.initials: ML
authors.lastname: Shahzad
authors.affiliation: Department of Orthopedic Surgery and Traumatology Unit-1, Mayo Hospital, Lahore.
authors.forename: Ahmad Humayun
authors.initials: AH
authors.lastname: Sarfraz
authors.affiliation: Department of Orthopedic Surgery and Traumatology Unit-1, Mayo Hospital, Lahore.
authors.forename: Syed Muhammad
authors.initials: SM
authors.lastname: Awais
keywords: Bone marrow, K-wire, Non-union, Delayed union.