PMC7468647_01
Anteroposterior radiograph showing a transverse thin fracture line with localized periosteal and endosteal thickening at the left subtrochanteric lateral cortex (a). Coronal STIR image showing focal cortical thickening with minimal edema of the adjacent bone marrow (b). Anteroposterior radiographs showing fracture region just after surgery (c) and complete bone repair at 7 months after surgery (d).
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AFF (Figures 1(a) and 1(b)). A biochemical investigation revealed a serum calcium of 9.2 mg/dl, phosphorus of 4.1 mg/dl, and 25-hydroxyvitamin D of 62 ng/ml, indicating vitamin D sufficiency. Anteroposterior radiograph just after surgery demonstrated bone marrow transplanted to the resected fracture region (Figure 1(c)). At 4 months after surgery, radiographs demonstrated apparent cortical bone remodeling, and complete bone repair was observed at 7 months after surgery (Figure 1(d)).
Intraoperative photograph showing the cylindrical bone marrow extracted from the hollow reamer (a). Histologic image at the fracture line in the excised lateral cortical bone. Photomicrograph showing few osteoblasts and little woven bone (hematoxylin-eosin, original magnification x 100) (b).
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Bone marrow remains inside the hollow reamer were extracted for use as an autologous bone graft (Figure 2(a)), which was transplanted to the resected fracture region. Histological examination showed few bone formation features at the fracture line in the excised cortical bone (Figure 2(b)).