Evaluating Effects of Autologous Bone Marrow Injection Obtained From Reaming of Intramedullary Interlocking Nailing in Closed Diaphyseal Fresh Tibia Fractures in Fracture Healing

Abstract

We performed a prospective, randomized controlled study on 60 patients with fresh closed diaphyseal tibial fractures to determine the effect of percutaneous autologous bone marrow injection on union rate. Sixty patients were randomized into a group of 30 patients each. 30 patients were treated with reamed intramedullary interlocking nail and 30 patients were treated with combination of reamed intramedullary interlocking nail and with 15-20 ml of autologous bone marrow injection at the fracture site percutaneously obtained at the time reaming. Fracture Union was defined clinically as ability to walk without any support and pain and radiologically as solid callus bridging the fracture fragments taking average mean time of 20.03 weeks in Interlocking nail group and 18.23 weeks in interlocking nailing with percutaneous autologous bone marrow injection (p value =0.03). Other possible determinants of union, complications and cost incurred in the treatment were similar in both the groups. The secondary procedures applied were more in the control group than in study[case] group.