Autologous marrow injection as a substitute for operative grafting.

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tibial nonunions. Connolly-JF; Guse-R; Tiedeman-J; Dehne-R Department of Orthopaedic Surgery, Creighton-Nebraska Health Foundation, University of Nebraska. Clin-Orthop. 1991 May(266): 259-70 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.