Original Research

Biomedical Research and Therapy

, 2:26

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Mini-invasive treatment for delayed or nonunion: the use of percutaneous autologous bone marrow injection

  • Trung Hau Le ThuaAffiliated withDept. of Plastic, Reconstructive & Hand Surgery, Center of Orthopaedic & Plastic Surgery, Hue Central Hospital
  • , Dang Nhat PhamAffiliated withDept. of Plastic, Reconstructive & Hand Surgery, Center of Orthopaedic & Plastic Surgery, Hue Central Hospital
  • , Quy Ngoc Bao LeAffiliated withDept. of Plastic, Reconstructive & Hand Surgery, Center of Orthopaedic & Plastic Surgery, Hue Central Hospital
  • , Phan Huy NguyenAffiliated withDept. of Plastic, Reconstructive & Hand Surgery, Center of Orthopaedic & Plastic Surgery, Hue Central Hospital
  • , Thi Thuy Hoa PhanAffiliated withCenter of Haematology, Hue Central Hospital
  • , Hoang Duy PhanAffiliated withCenter of Haematology, Hue Central Hospital
  • , Phuoc Quang LeAffiliated withCenter of Haematology, Hue Central Hospital
  • , Willy Denis BoeckxAffiliated withDept. of Plastic Surgery, Brugmann University Hospital, Free University of Brussels
  • , Albert De MeyAffiliated withDept. of Plastic Surgery, Brugmann University Hospital, Free University of Brussels

Abstract

Delayed union or nonunion of bone fracture is becoming less frequent, but still remains a challenging clinical problem. Autologous cancellous bone grafting that is the gold standard method, often involves donor site morbidities and complications. Once these fractures have been mechanically stabilized, other local factors should be investigated to promote delayed healing. The purpose of this study was to evaluate the initial outcome of the percutaneous injection of autologous bone marrow after concentration for the treatment of delayed or nonunion. Our subjects included 10 patients (3 female, 7 male) with an average age of 28 years. All fractures were mechanically stabilized after accident.Delayed or nonunion affected the femur in 2 patients, the tibia in 5 patients, the humerus in 2 patients, and the ulna in 1 patient. Bone marrow aspirates were obtained from both the posterior superior iliac crest. Bone marrow aspiration concentrate was produced via density gradient centrifugation. Trocars were inserted in the delayed or nonunion gap under fluoroscopic guidance. The bone marrow aspiration concentrate was injected slowly. All of 10 delayed or nonunion healed after treatment with percutaneous injection of autologous bone marrow. The mean time for new bone formation was 3.3 months, for clinical union was 5.2 months, and for radiological union was 11.8 months. The result of current study is encouraging in the initial outcome and percutaneous bone marrow implantation could be an effective and safe treatment for delayed or nonunion.

Keywords

Delayed union nonunion mesenchymal stem cells bone marrow aspiration concentrate percutaneous autologous bone marrow injection