Use of Fibrin Glue as a Surgical Adjunct in Bone Grafting of Fracture Non-unions
https://doi.org/10.5704/MOJ.2407.007
- Author:
Kunnasegaran R
1
;
Ng JW
1
;
Kwek EBK
2
Author Information
1. Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
2. Department of Orthopaedic Surgery, Woodlands Health, Singapore
- Publication Type:Journal Article
- Keywords:
fractures, ununited, fibrin tissue adhesive, bone transplantation, fracture healing
- From:Malaysian Orthopaedic Journal
2024;18(No.2):49-54
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Non-union of long bones is a common
challenge in the treatment of fractures. Bone grafting is
commonly used to treat atrophic non-union, but mechanical
displacement of the graft may occur, resulting in delay or
failure of treatment. Fibrin glue has demonstrated positive
results in management of bone defects in neurosurgery and
oromaxillary facial surgery, however, there has yet to be any
study on its use in long bone fractures.
Materials and methods: We conducted a prospective
randomised controlled trial at a single tertiary centre
involving adult patients with long bone fractures that had
undergone non-union and requiring bone grafting only.
Autologous iliac crest bone graft was applied to the debrided
non-union site, with additional fibrin glue applied for the
intervention arm. Patients were followed-up with serial
radiographs until clinical and radiographical union.
Results: Ten patients (3 male, 7 female), of mean age 41.7
(19 – 63) were recruited over five years, with one drop out.
Eight out of nine fractures united after treatment. One patient
underwent hypertrophic non-union requiring re-fixation and
bone grafting. There was no difference in the time to union
for patients in the fibrin glue group (19.5 weeks) versus the
control group (18.75 weeks) (p=0.86). There were no
complications sustained from usage of fibrin glue.
Conclusions: Fibrin glue appears to be a safe adjunct for
treatment of non-union of long bone fractures across varying
fracture sites by holding the bone graft in place despite not
demonstrating a faster time to union.
- Full text:202408211247246849516.2024my1372.pdf
