Khatri B
Central Institute of Orthopedics, VMMC And Safdarjung Hospital, New Delhi Delhi, India
Title: ROLE OF CT SCAN GUIDED BONE MARROW INJECTION IN POSTOPERATIVE CASES OF FRACTURE FIXATION WITH NONUNION IN LONG BONES
Biography
Biography: Khatri B
Abstract
Introduction: Fracture non-union is a relatively common problem faced by orthopedic surgeons after operative fracture fixation. Percutaneous Bone marrow injection given at non-union site has successfully shown union with significant low morbidity as compared to traditional open bone grafting. The purpose of our study was to use CT scan guidance to accurately locate the exact site of non-union, deliver an effective shot of autologous bone marrow injection and assess union time. Method: Under strict aseptic precautions bone marrow aspiration was done from posterior iliac crest using core biopsy needle in a heparinized syringe. Under CT guidance, multiple punctures were done over sclerosed non united fracture ends followed by percutaneous injection of bone marrow to stimulate union. All patients were followed up with serial radiographs and clinically with appropriate scoring systems. Results: 30 patients were selected for hospital based interventional based study with average time after operative fracture fixation of 9.5 months. After bone marrow injection, Follow-up period ranged from 6 to 8 months with average union time of 4 months and complete union in 24 out of 30 patients (80%). Failure was reported in six patients (20%).Conclusion: CT SCAN guided bone marrow injection is an effective method for treatment of delayed or non-union fractures with low complications. It has significant low rates of morbidity as compared to autologous bone grafting procedures and it reduces patient’s expenditure, hospital stay and gives good functional results. It can be tried for non-union before going directly to gold standard re-fixation and autologous bone graft