Publication:

Effectiveness of percutaneous autologous bone marrow injection in delayed and non-union of long bones after definitive fixation

Background Delayed and non-union of long bones remain challenging complications despite stable fixation. Percutaneous autologous bone marrow injection (PABMI) provides osteogenic stimulation without the morbidity of open grafting.

Methods This prospective observational study included 32 patients with delayed or non-union following internal fixation. Forty to sixty milliliters of autologous bone marrow aspirate was collected from the anterior iliac crest and injected percutaneously around the non-union site under fluoroscopic guidance. Patients were followed clinically and radiologically at 4, 8, 16, and 24 weeks.

Results Radiological union improved progressively, from 3.1% at 4 weeks to 87.5% at 24 weeks (p=0.02). Patients operated within 1 week of injury and those presenting within 12 months of fixation had significantly higher union rates (p=0.021 and p=0.0038). No major complications were observed apart from transient donor-site pain.

Conclusion PABMI is a safe, simple, and effective biological method for achieving union in delayed and non-union of long bones, with earlier intervention significantly improving outcomes.