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

Abstract

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.