Objective: To evaluate the initial clinical effect of the autologous bone marrow integrating artificial bone and ilium periosteum transplantation in treatment of problematic nonunion.
Methods: From January 2004 to July 2006, 12 patients (13 limbs)with problematic nonunion were treated with autologous bone marrow integrating artificial bone and ilium periosteum. There were 8 males and 4 females, aged 17-58 years old. The position of nonunion were the tibia in 7 limbs, the femur in 3 limbs, the humerus in 2 limbs. The operated number was 1-4, mean 2.5. The time from injury to therapy was 13 months to 9 years, mean 47.6 months. The bone defect distance was 6-30 mm (mean 15 mm) through 1 : 1 X-rays before operation. Eleven limbs were treated by internal fixation (10 limbs by the bone nail and 1 limb by the limited contact-dynamic compression plate), 2 limbs were treated by the external fixation. The X-ray films were taken at 1 day, 1, 3, 6, 9, 12 months after operation to observe fracture union.
Results: All patients were followed up for 12-26 months (mean 17.5 months) and achieved union within 4-7 months (mean 6 months). No deformity of rotation, angulation and crispation occurred in 13 limbs, but functional impairment occurred in 6 limbs after union of fracture.
Conclusion: Autologous bone marrow integrating artificial bone and ilium periosteum transplantation for treatment of problematic nonunion has the satisfactory result.