Percutaneous versus open bone grafting in the treatment of tibial fractures: a randomized prospective trial.

PURPOSE: To compare the results between percutaneous bone grafting and open bone grafting of tibial shaft fractures.

METHOD: 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.

CONCLUSION

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.