A prospective randomized trial of percutaneous marrow injection in a series of closed fresh tibial fractures

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.