COMPARISON OF AUTOGENOUS-BONE-GRAFT VS BONE-SUBSTITUTE IN NONUNION OF LONG BONES IN TERMS OF EARLY UNION

Background: Nonunion of long bones remains a challenge in orthopedic surgery, often resulting in pain, disability, and impaired function. While autogenous bone grafts (ABG) are traditionally preferred for their osteogenic properties, their use is limited by donor site morbidity. Bone substitutes like hydroxyapatite (HA) have emerged as alternatives due to their osteoconductive capabilities. Comparative studies are necessary to evaluate the effectiveness of ABG versus HA in achieving early union in nonunion cases. Objective: To compare the effectiveness of autogenous bone grafts and hydroxyapatite bone substitute in promoting early union in long bone nonunion. Methods: A randomized controlled trial was conducted at General Hospital, Lahore, Pakistan, from January 2021 to January 2023. Eighty patients with nonunion of long bones, aged 15 to 70 years, were enrolled via probability randomized sampling. Patients were randomly assigned to two groups: Group A received autogenous bone grafts, while Group B was treated with hydroxyapatite bone substitute. Clinical and radiological evaluations were conducted at regular intervals to assess bone union. Statistical analyses were performed using an independent t-test, with significance set at p < 0.05. Results: The mean age of patients in Group A was 27.32 ± 12.17 years, while in Group B it was 31.10 ± 10.12 years. Group A comprised 37 males (92.5%) and 3 females (7.5%), whereas Group B included 34 males (85%) and 6 females (15%). Union rates were 90% in Group A and 85% in Group B, with no statistically significant difference (p = 0.499). Conclusion: This study indicates that both autogenous bone grafts and hydroxyapatite bone substitutes are effective in treating long bone nonunion, with slightly higher union rates observed in the ABG group. Both modalities provide viable options for promoting bone healing in nonunion cases.