PROJECT TITLE :
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RESULTS OF TREATMENT OF DELAYED UNION OF LONG BONES BY BONE MARROW GRAFT.
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SUMMARY :
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Delayed & Non- unions are common complications of fracture management. Delayed unions are interval periods in the stage of bone union when the process may progress to complete union or the end result maybe non-union. The factors that influence this progression one way or the other are difficult to define. Various methods have been used to enhance union. These include continuous immobilization in plaster, stimulation of osteogenesis by drugs e.g. Vitamin D3 and calcium, electro-magnetic stimulation, distraction and compression osteogenesis by Ilizarov technique, injection of autogenous bone graft and more specifically Bone morphogenic protein (BMP) into the fracture site. No data is available to show that any of the above mentioned method is superior to the other.
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While the treatment of non-union is a major operation, every attempt should be made to achieve union in delayed unions to avert a major operation. Any major operation means occupation of hospital bed, increased hospital expenses, and subjecting the patient to the risk of operation.
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Bone grafts in differt forms such as autogenous cancellous grafts, bone marrow grafts, and bone morphogenic protein have been used to induce ostegenesis and union. Injection of autogenous bone marrow have been reported to have had success. The approach has a sound scientific basis.
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The objective of this study is to observe, record and report the results of treatment of delayed union of fracture by injecting autogenous bone graft at the fracture sitein an attemt to stimulate osteogenesis and union.
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All patients attending the Dept. of Orthopaedic Surgery at Dhaka Medical College Hospital with delayed union will be included in this protocol with the permission of the patient. The protocol include aspiration of autogenous bone marrow and injection of this material into the fracture site under C-arm guide. The procedure can be performed as a day case. The procedure will be repeated at monthly intervals, usually for 3 to 4 sittings, until a final decision can be made about the fate of the fracture site i.e. progression to union or failure to achieve union.
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If the treatment of delayed union of long bones by autogenous bone graft prove to be a successful method of treatment, then this modality of treatment will avert possibility of a major surgery, saving the patient from risk of a operation and expenses and also the load on hospital and expense.
FOR FURTHER INFORMATION, CONTACT:
Dr. Md. Iqbal Qavi
Assistant Professor
Dept. of Orthopaedic Surgery
Dhaka Medical College Hospital, Dhaka
E-mail:qavi@bdonline.com
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This project is an on going research work being carried out at the Dept. of Orthopaedic Surgery at Dhaka Medical College Hospital, Dhaka. The preliminary results were presented at the last (12th)National Conference of Bangladesh Orthopaedic Society. The project has been submitted for financial support from the Bangladesh Medical Research Council ( no. 192).
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