الفهرس 
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Abstract
Most important local causes of non union and delayed union following surgical fixation includes: inadequate fracture fixation, impaired blood supply to fracture site and nature of fractures. Autogenous bone grafting is the most commonly method used in the surgical management up to now. Recent studies focused on less invasive technique including application of EMF, rhBMP-7, PRP, pulsed low intensity ultrasound, extracorporeal shock waves and bone marrow injection.
PRP has three or more times of normal amount of platelets that enhance body self healing and shorten recovery time as it contains growth factors and cytokines that promote healing. The use of bone marrow is a minimally invasive technique and it contains progenitor cells that accelerate fracture healing.
PRP is prepared by centrifuging autologous anticoagulated whole blood by obtaining a 60cc of venous blood and obtain upper layer & superficial buffy coat & perform 2nd spin step to obtain PRP, the 60 ml of blood provide 8-10 ml of PRP for injection.
Autogenous bone marrow graft is effective for the stimulation of bone formation and fracture healing percutanous bone marrow grafting of bone defects gives a successful union without any growth factors. Injected bone marrow concentration into a gap of non infected atrophic non union achieved union in all cases.
Bone marrow aspiration can be obtained from posterior iliac wing and increase cell concentration with centrifugation at 400 times gravity for 10 min, and delivers 50 ml of concentrated marrow that obtained from 300 ml of non centrifuged marrow.
This study was done at Menufia university in the period between 2016 to 2019. We examined 30 of patients with delayed and non union diaphyseal fractures treated with of PRP and bone marrow concentrate and compare between results and follow patients for 6 months. Patients were subjected to history taking, local and radiological examinations.
Our study showed that the mean age was 28 years in the patients injected with bone marrow and 34.47 years in the patients injected with PRP with age ranging from 20 – 60 years. Statistically, there was a significant difference between bone marrow injection group and PRP injection group as regard age. We had 30 patients with the incidence of 80% : 20% male-to-female ratio. There were 24 tibial fractures, 2 ulnar fractures, 2 humerus fractures and 2 femur fractures. There was non statistically significant difference between the two injection groups as regard Non union site .
Our study showed statistically significant difference between the two injection groups as regard fixation and non statistically significant differences between the two injection groups as regard weight bearing and RUS union score.
There was non statistically significant difference between RUS union score and sex in the two injection groups, but there was statistically significant deference between RUS union score and Non union site in PRP groups. Also, there were highly statistically significant differences between RUS union score and fixation, pain and weight bearing in the two injection groups.