Percutaneous versus Open Bone Grafting in the Treatment of Tibial Fractures: A Randomized Prospective Trial
Jakravoot Maneerit MD*, Surapoj Meknavin MD*, Sukit Hanpanitkitkan MD*
Affiliation : * Department of Orthopaedic Surgery, Bangkok Metropolitan Administration Medical College and Vajira Hospital
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.
Keywords : Bone graft, Percutaneous, Fracture tibia
