Injection of Autologous Bone Marrow versus Hanging Cast in Treatment of Humeral Fracture

Accounting for approximately 5% of the bone fractures in the human body, the shaft of the humerus is one of the most common long bone fracture sites. Humerus fracture may be associated with several complications: radial nerve damage, bone infection, and non-union and mal-union of the bone. Autologous bone marrow injections are considered to decrease these complications and accelerate union and healing in non-unions.
The present study investigates the effect of autologous bone marrow injections on the union rate in humerus fractures.
Patients and For this interventional clinical trial, patients with humerus fracture referred to the emergency ward of Baqiyatallah and Imam Hossein hospitals were enrolled in the study. Thirty-six patients with a mean age of 33.97 ± 10.08 years underwent analysis. Demographic information, type of fracture, para-clinical test results, and initial X-ray results were recorded on a predesigned questionnaire. Patients were randomly assigned to either bone marrow injection or cast only (non-surgical) treatment. Patients were followed up one, two, three, four, six, twelve, and sixteen weeks after injection or cast (non-surgical) therapies with lateral and anterior-posterior radiography. Details regarding union time and mal-union or non-union were recorded.
The mean time of union was 8.54 ± 3.41 weeks for the individuals followed in the study. On average, union took 7.04 ± 2.49 weeks for the injection group, while it took 10.41 ± 3.26 weeks for the control group (P = 0.002). In the sixth week, 16 (80%) patients from the injection group and 4 (25%) individuals from the control group had radiographic changes (P = 0.001). Union changes were seen in 19 (95%) patients from the injection group and 12 (75%) individuals from the control group at the end of the twelfth week (P = 0.108). All patients in both groups had complete union 16 weeks after their respective treatments (P = 0.31).
Due to the high risk of non-union and mal-union in humerus shaft fracture, and because applying this simple and inexpensive technique significantly decreased these complications, injecting autologous bone marrow grafts is recommended for accelerating union in cases of humerus fracture.