Autologous Marrow Injection as a Substitute for Operative Grafting of Tibial Nonunions

TLDR

Autologous marrow injection was applied to 20 tibial nonunions over five years, with half treated by cast immobilization and half by intramedullary nail fixation. The injections achieved union in 8 of 10 cast‑treated and all 10 nail‑treated fractures, matching the efficacy of traditional open grafting while offering a renewable, less disadvantageous osteogenic source.

Abstract

Autologous marrow injection was used to stimulate healing in 20 ununited tibial fractures over a five-year period. The technique was employed in conjunction with cast immobilization in ten cases and intramedullary nail fixation in ten cases. Marrow stimulated a callus formation sufficient to unite eight of the ten nonunions immobilized with casts and all ten of the fractures immobilized by intramedullary nails. Bone-marrow injection was as effective as past open autologous grafting but with considerably fewer disadvantages. The technique provides a promptly renewable and reliable source of osteogenic stem cells with numerous advantages compared with standard open-grafting techniques.