Assessment of prophylactic bone grafting effect on union of open tibial fracture

Objective: The fracture of the tibial shaft is the most common fracture of long bone in human. Considerable proportion of this fractures are open fractures. Treatment of open fractures is one of the orthopedic problems. In the developing country with economic problem, early mobilization and returning to work may be important for people. We compared result of treatment with addition of autogenus bone graft in two different time periods in two groups.

Methodology: In this study, 144 patients with open tibial fracture were randomly divided in two groups and were treated with autogenus bone graft at two different time intervals, the first group in the end of third week and second group in the end of sixth week. All Patients were followed up periodically in first two month every month and then every two weeks. T-test was used for comparison. SPSS ver. 13.0 (SPSS Inc, Chicago, IL, USA) was used for analysis.

Results: The mean fracture healing time in the first group (with bone graft in 3rd week) was 14.24±4.4 week and in the second group (with bone graft in 6th week) was 16.4±5.4 week and the difference was statistically meaningful. Differences in the rate of delayed union and none union in two groups were statistically insignificant. In addition to time of bone graft, the age, gender, injury mechanism, fixation method, cigarette smoking and drug abuse were studied in two groups. The difference as regards these factors in two groups was statically insignificant.

Conclusions: Achievement of autogenus bone graft in open tibial fracture at the end of third week causes reduction of union time from 16.4 week to 14.4 week without increment of deep infection.