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Related Experiment Videos

Posterolateral bone graft of the tibia.

J M Simpson1, N A Ebraheim, H S An

  • 1Department of Orthopaedics, Medical College of Ohio, Toledo 43699.

Clinical Orthopaedics and Related Research
|February 1, 1990
PubMed
Summary

Posterolateral bone grafting effectively treated high-energy tibial fractures, achieving a 97% union rate in open fractures, including those with delayed union or nonunion. This surgical technique promotes rapid healing for severe bone injuries.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Bone Healing Research

Background:

  • High-energy tibial diaphyseal fractures often present as open injuries with significant soft-tissue damage.
  • Comminution and segmental bone loss complicate the management of these severe tibial fractures.
  • Motorcycle accidents, pedestrian impacts, and motor vehicle collisions are common causes of these high-energy injuries.

Purpose of the Study:

  • To evaluate the efficacy of posterolateral bone grafting in treating high-energy tibial diaphyseal fractures.
  • To assess healing rates and time to union for open tibial fractures managed with posterolateral bone grafts.
  • To determine the effectiveness of this technique in cases of delayed union and established nonunion.

Main Methods:

  • A retrospective review of 30 patients with high-energy tibial diaphyseal fractures treated between 1984 and 1987.

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  • All fractures were open, with many classified as Gustillo Type III, involving substantial soft-tissue injury, comminution, or bone loss.
  • Posterolateral bone grafting was performed either within six months of injury or after established nonunion.

    • Main Results:

    • A high union rate of 97% (29 out of 30 fractures) was achieved.
    • Healing time post-grafting ranged from 3 to 12 months, averaging 4.7 months.
    • One patient required below-knee amputation due to chronic osteomyelitis and nonunion.

    Conclusions:

    • Posterolateral bone grafting is a consistently effective method for achieving rapid healing in delayed union and established nonunion of high-energy tibial fractures.
    • The technique demonstrates a high success rate in managing complex open tibial fractures with significant bone loss.
    • This surgical approach offers a reliable solution for promoting bone consolidation in challenging fracture scenarios.