Percutaneous versus open bone grafting in the treatment of tibial fractures: a randomized prospective trial.
OBJECTIVE
To compare the results between percutaneous bone grafting and open bone grafting of tibial shaft fractures.


METHODS
Thirty tibial fractured shafts with a delayed union or a high-energy tibial fractures which required early prophylaxis bone grafts were randomized to either percutaneous bone graft (n= 15) or open bone graft (n=15). One patient from the open bone graft group was lost to follow-up. Characteristics of the patients were similar in both groups.


RESULTS
The mean length of follow-up was 2.5 years. Percutaneous bone graft technique was associated with significantly less blood loss (p<0.01) and shorter operative time (p<0.01). One patient in the percutaneous group had posterior tibial nerve palsy postoperatively, which recovered completely after 6 weeks. There were no differences in rate of union, healing time of the successful cases, postoperative pain and hospital stay.


CONCLUSIONS
The percutaneous technique has effective results similar to the open technique in promoting union of tibial fractures. It should be considered as a useful alternative to the open bone graft technique.
Maneerit
Jakravoot
J
Department of Orthopaedic Surgery, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Thailand. maneerit@hotmail.com
Meknavin
Surapoj
S
Hanpanitkitkan
Sukit
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D018709:Statistics, Nonparametric; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome