Abstract
We performed a prospective, randomized study on 40 patients with fresh closed fractures of the tibial shaft to determine the effect of autologous bone marrow injection on the union rate. Forty patients were randomized to two injections with 15 ml of autologous bone marrow injections at the fracture site and casting or conventional casting. Fracture union measured by absence of localized tenderness and mobility and bridging of three out of four cortices at the fracture site on plain roentgenograms was assessed at 3, 4, and 5 months of treatment. All fractures receiving bone marrow injections united in 3.65±0.49 months; 19/20 fractures treated conventionally united in 4.31±0.48 months (p=0.0004). Other possible determinants of union, complication rates, and cost incurred in the treatment were similar in the two groups.
Résumé
Nous avons exécuté une étude prospective et randomisé sur 40 malades avec des fractures diaphysaires tibiales fermées fraîches pour déterminer l’effet d’injection de la moelle osseuse autologue sur le taux de consolidation. Quarante malades ont été randomisés avec deux injections de 15 ml de moelle osseuse autologue à l’emplacement de la fracture et contention par plâtre ou contention conventionnelle par plâtre. La consolidation a mesuré par l’absence de mobilité localisée et par la fusion de trois des quatres corticales sur des clichés ordinaires réalisés à 3, 4 et 5 mois de traitement. Tout les fractures qui ont recus des injections de moelle ont consolidé en 3.65±0.49 mois; 19/20 fractures traitées conventionnellement ont consolidé dans 4.31±0.48 mois (p=0.0004). Les autres déterminants possibles de la consolidation, la fréquence des complication et le coût du traitement était semblable dans les deux groupes.
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