Percutaneous Autologous Bone Marrow Injection in the Treatment of Delayed Union of Long Bone Fractures After Definitive Fixation

Abstract

Background: Delayed union of long bone fractures remains a significant challenge in orthopedic practice despite advances in fixation techniques. Autologous bone marrow injection has emerged as a minimally invasive biological method for enhancing fracture healing by delivering osteogenic progenitor cells and growth factors directly to the fracture site.
Aim: To evaluate the effectiveness of percutaneous autologous bone marrow injection in the treatment of delayed union of long bone fractures following definitive fixation.
Methods: A prospective observational study was conducted in the Department of Orthopaedics, Patna Medical College Hospital (PMCH), from January 2024 to January 2026. Thirty-five patients with delayed union of long bone fractures after definitive fixation underwent percutaneous autologous bone marrow injection. Clinical and radiological outcomes were assessed at regular follow-up intervals. Fracture union rates, time to union, functional outcomes, and complications were analyzed.
Results: Among 35 patients, 30 (85.7%) achieved complete fracture union following bone marrow injection. The mean time to radiological union was 14.2 ± 3.8 weeks. Tibial fractures constituted the majority of cases (42.9%). Union rates were significantly higher among patients treated within six months of injury compared with later intervention (p=0.018). No major procedure-related complications were observed.
Conclusion: Percutaneous autologous bone marrow injection is a safe, effective, and minimally invasive treatment modality for delayed union of long bone fractures. Early intervention appears to improve healing outcomes and may reduce the need for secondary surgical procedures.