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CASE REPORT   

Minerva Ortopedica e Traumatologica 2017 September;68(3):198-202

DOI: 10.23736/S0394-3410.17.03839-5

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Femoral diaphysis exposed displaced fracture treated with external fixation and bone marrow concentrate infiltrations

Silvia RICHETTA , Antonio MEMEO, Fabio VERDONI

Gaetano Pini Orthopedic Institute, Milan, Italy


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Comminuted exposed and displaced diaphyseal fractures of the femur in pediatric and adolescent patients are rare and usually resulting from high-energy trauma. Their treatment is made difficult not only by the potential injuries associated (head trauma, thoracic and abdominal) but also by many complications related to the type of fracture, which include delayed unions and nonunions. A young 16-year-old male with a comminuted displaced and exposed diaphyseal fracture of the right femur was treated at our department after a stabilization of the fracture in emergency in an another operative unit. The fracture was found to be comminuted, displaced and exposed with a loss of substance of a bone wedge of about 7 cm. The fracture was surgically reduced, synthesized with metal hoops and stabilized with an MMF external fixator. To facilitate the consolidation, the patient was subjected to 10, 60 and 90 days from the first intervention to three infiltration at the level of the fracture of concentrated autologous mononuclear cells of bone marrow origin. Regular clinical and radiographic controls were performed to evaluate the progression of the consolidation of the fracture and the functional recovery, which are complete in 12 months from the first surgery. The infiltrative treatment with concentrated bone marrow derived stem cells, associated with an anatomic reduction and with a stable synthesis, demonstrated a valuable aid in the healing of the fracture and in replenishing the femoral bone loss.


KEY WORDS: Bone marrow - Mesenchymal - Mesenchymal stromal cells - Fractures, open

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