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Multidirectional percutaneous drilling and autologous bone marrow injection for the treatment of femoral diaphyseal nonunions: a prospective interventional study

Authors Li M, Meng Y, Li Y, Long A, Lv H, Yin P, Zhang L, Tang P

Received 20 March 2019

Accepted for publication 25 July 2019

Published 19 August 2019 Volume 2019:15 Pages 1003—1011

DOI https://doi.org/10.2147/TCRM.S209393

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang


Ming Li,1,* Yutong Meng,2,* Yi Li,1 Anhua Long,3 Houchen Lv,1 Pengbin Yin,1 Licheng Zhang,1 Peifu Tang1

1Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, People’s Republic of China; 2Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, People’s Republic of China; 3Department of Orthopaedics, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, People’s Republic of China;

Correspondence: Peifu Tang; Licheng Zhang
Department of Orthopedics, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing 100853, People’s Republic of China
Tel +86 10 6821 2342
Email pftang301@163.com
pftang301@163.com

*These authors contributed equally to this work

Background: To examine the outcomes of multidirectional percutaneous drilling and autologous concentrated bone marrow (BM) transplantation for atrophic femoral diaphyseal nonunion characterized by intact hardware and mechanical stability at the nonunion site.
Methods: Fourteen patients (22–63 years of age) were admitted to our hospital with atrophic femoral diaphyseal nonunion. All patients were treated with a combination of multidirectional percutaneous drilling and autologous concentrated BM transplantation. Radiographic evaluation was conducted every month after transplantation until bone healing was achieved.
Results: Bony union was achieved in 13 of the 14 patients (92.9%) after an average of 3.9 months (range: 2.5–6 months). The average radiographic union scale in tibial (RUST) scale score improved significantly from the preoperative period (6.15±1.21) to follow-up (11.23±0.73; P<0.05). The mean follow-up after transplantation was 31.4±9.5 months (range: 18–50 months). At the final follow-up, the quality of function had improved significantly, allowing a return to normal activities.
Conclusion: Combined multidirectional percutaneous drilling and autologous concentrated BM transplantation is an easy, safe, inexpensive, and efficacious method to treat atrophic femoral diaphyseal nonunion characterized by intact hardware and mechanical stability at the nonunion site.
Trial registration number: ISRCTN29808592

Keywords: autologous bone marrow injection, multidirectional percutaneous drilling, femoral diaphyseal fracture, nonunion


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