title: Clinical outcomes of autogenous cancellous bone grafts obtained through the portal for tibial nailing.
abstract: BACKGROUND
  The purpose of this study is to introduce and review the clinical outcomes of a new technique for harvesting autogenous cancellous bone grafts in association with tibial intramedullary (IM) nailing.
  
  
  METHODS
  We retrospectively reviewed 21 patients who received autogenous cancellous bone grafts obtained from the entry portal of a tibial IM nail for fracture gaps, malalignment or nonunion in the lower extremities. All patients were scheduled to receive IM nailing or had already received IM nailing for the fixation of an ipsilateral tibia shaft fracture. A total of 33 patients who received only tibial IM nailing were selected as a control group. Through the follow-up, postoperative complications related to the bone harvest were monitored. Further by taking serial X-rays, radiographic changes of the donor site and the knee joint were closely observed. Knee pain (visual analogue scale (VAS)) and function (Lysholm knee score) were compared between the study group and the control group.
  
  
  RESULTS
  At the last follow-up, the average VAS in the study group was 1.28 (0-5), which was not significantly different from the control group (VAS: 1.36, range 0-7) (P=0.985). The range of motion of the knee joint was similar in both groups, averaging 130.23° (range: 115-135°) and 131.36° (range: 115-135°), respectively. There was no significant difference in the Lysholm knee score between the study and control groups (P=0.610). All patients exhibited complete fracture healing at an average of 6 months and no complications associated with the bone donor site were observed.
  
  
  CONCLUSIONS
  By using the new technique, autogenous cancellous bone grafting can be performed conveniently and safely to treat fracture gaps, malalignment or nonunion in the lower extremities without additional morbidity at the donor site.
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Moses
authors.initials: M
authors.lastname: Lee
authors.forename: Hyung-Keun
authors.initials: HK
authors.lastname: Song
authors.forename: Kyu-Hyun
authors.initials: KH
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome