Treatment of high-energy tibial shaft fractures with internal fixation and early prophylactic NovaBone grafting.
OBJECTIVE
To evaluate the safety and efficacy of early NovaBone grafting in accelerating healing of high-energy tibial shaft fractures.


METHODS
In a prospective, randomized, controlled study 78 patients with open or closed tibial shaft fractures were treated with reamed interlocking nails, combined with NovaBone grafting. Forty patients were randomly assigned to the experimental group (with NovaBone grafting at fracture site), and 38 to the control group (without NovaBone grafting).


RESULTS
All patients were followed up for an average of 8 months (range 6-18 months). The average fracture healing time was 12 weeks (range 8-16 weeks) in the experimental group, and 19 weeks (range 12-36 weeks) in the control group (P < 0.01). No delayed union or nonunion was found in the experimental group, but four cases (10.5%) in the control group were found to heal spontaneously between 7 and 8 months. When the data were analyzed at week 12 and week 26 according to the criteria of Johner and Wruhs, 88% and 100% of the cases in the experimental group were rated as excellent and good respectively, but in the control group, 50% and 89% were rated as excellent and good respectively, these being significant differences (P < 0.05).


CONCLUSIONS
Internal fixation supplemented with early prophylactic NovaBone grafting of high-energy tibial shaft fractures is a safe and effective treatment which accelerates fracture healing.
Department of Orthopaedics, First Affiliated Hospital of Suzhou University, Suzhou, China. sun_junying@hotmail.com
Jun-ying
JY
Sun
Si-chun
SC
Hao
Rong-bin
RB
Sun
Yu-sheng
YS
Yang
D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D001858:Bone Nails; D018786:Bone Substitutes; D002516:Ceramics; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D005594:Fracture Fixation, Intramedullary; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
D001672:Biocompatible Materials; C022107:Bioglass; D018786:Bone Substitutes