Abdullah KÜÇÜKALP, Bülent ÖZDEMİR, Erol TEMİRCİ

Otojen kemik iliği enjeksiyonunun uzun kemik kaynamamış kırıklarına etkisi

Amaç: Kaynamamış kırığı olan hastalarda anterior iliak kanattan alınan kemik iliğinin kırık hattına enjekte edilmesinin kırık kaynamasına etkisi araştırıldı. Gereç ve Yöntem: Çalışma kliniklerimize müracaat eden kaynamamış kırığı olan ve kemik iliği enjeksiyonu uygulamasını kabul eden bu uygulama ile takip ve tedavi edilen hastaların retrospektif olarak incelenmesi sonucu hazırlandı. Çalışmaya Kasım 2016 Aralık 2019 tarihleri arasında müracaat eden uzun kemik diafiz ve metafiz kırığı kaynamaması olan 13 hastanın 14 kemiği dahil edildi. Hastalara lokal anestezi altında anterior iliak kanattan kemik iliği aspirasyonu yapılarak lokal anestezi altında kırık hattına skopi kontrolünde enjekte edildi. Tüm hastalar aylık olarak ön-arka ve yan grafiler ile izlendi. Enjeksiyon işlemi yedi hastaya üç defa 6 hastanın yedi kaynamamış kırığına 2 defa tekrar edildi. Bulgular: Toplamda 14 hastanın 11 kırığı kaynadı. Üç kırıkta kaynama elde edilemedi. Kaynama elde edilemeyen kırıklarda boşluk miktarı 2 mm üzerinde idi. Kırık kaynama oranı % 79 olarak bulundu. Hastalara uygulanan ortalama enjeksiyon sayısı 2.5 idi. Tespit tekniği ve kaynamama tipi ile kaynama arasında anlamlı bir ilişki bulunamadı. Sonuç: Kemik iliği enjeksiyonu kaynamamış uzun kemik kırıkları tedavisinde ucuz etkili ve günübirlik cerrahi uygulaması olarak güvenli bir yöntemdir.

Anahtar Kelimeler:

Kemik iliği, kaynamama tedavisi, günübirlik cerrahi, uzun kemik, kemik kaynaması

Effect of autogenous bone marrow injection on long bone nonunion fractures

Purpose: The impact on bone union of injecting bone marrow from the anterior iliac crest was examined in patients with non-unions. Materials and Methods: The present study was prepared following a retrospective study on non-union patients who applied to our clinics who accepted bone marrow injection and were followed up and monitored after the procedure. A total of 14 bones from 13 patients with long bone diaphysis and metaphysis non-union were included in the study from among patients who applied during the dates of November 2016 – December 2019. Bone marrow aspiration from the anterior iliac crest was conducted on the patients under anesthesia which was injected to the fracture line under local anesthesia and fluoroscopy. All patients were monitored on a monthly basis with front-rear and side radiography. The injection operation was conducted three times on seven patients and 2 times on a total of seven non-unions in 6 patients. Results: A total of 11 unions took place in 14 patients. A union could not be attained in three fractures. The gap was over 2 mm in fractures without union. Fracture union ratio was obtained as 79 %. The mean injection number applied on the patients was 2.5. A statistically significant correlation could not be identified between the fixation method and non-union type and union. Conclusion: Bone marrow injection is a cheap, effective, easy to use and safe surgical method for the treatment of long bone fractures with non-union.

Keywords:

Bone Marrow, non-union treatment, out-patient surgery, long bone, bone union,

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