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Percutaneous versus Open Bone Grafting in the Treatment of Tibial Fractures: A Randomized Prospective Trial


Jakravoot Maneerit MD*,
Surapoj Meknavin MD*, Sukit Hanpanitkitkan MD*

* 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.

Keyword : Bone graft, Percutaneous, Fracture tibia

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