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Trauma

THE USE OF THE DEMINERALIZED BONE MATRIX (DBM)?PLATELET RICH FIBRIN (PRF) AND BONE MARROW CONCENTRATE (BMC) REDUCE HEALING TIME IN FRACTURE DELAYED UNION

International Society for Fracture Repair (ISFR)



Abstract

Introduction

The delay looks radiographically as a fracture callus not very evident or absent 6 months after osteosynthesis. Patients undergo a long period of immobilization and this fact causes the increase the social cost of the disease. The technique we suggest aims to the reduce the period of immobilization and as a consequence the management costs of the disease.

Materials and methods

Our technique includes the infiltration of the delay focus with platelet rich fibrin, bone marrow concentrated and demineralized bone matrix. Outpatients and radiographic checks were carried out 3, 6 and 12 months after surgery. The treatment was considered fail in case of absence of bone callus at 3 out of 4 corticals at the rx after 6 months from surgery.

Results

From November 2008 we treated 14 patients (average age 35 years, range 18 to 53). The treatment was performed after an average period of 14 months (range 5 to 38) from the fracture. The average follow up was 12 months (range 3–30). After 3 months from surgery, seven patients bear full load, did not feel pain and X-ray showed an increase of osteogenesis. Two cases failed; in one of them the patient underwent another infiltration and in the other one we replaced the fixation.

Conclusion

Our tecnique lets a reduction of healing times in patients with delay and can be performed through the One Day Surgery programme.