Autologous bone grafting in the treatment of atrophic nonunion caused by open tibia fractures with external fixation

Abstract

Objective To investigate the therapeutic effect of autologous bone grafting on atrophic nonunion caused by open tibia fractures with external fixation. Methods Thirty-eight patients were enrolled in this study from June 2011 to June 2014 for tibial atrophic nonunion. All the patients were treated by auto bone graft via the posterior middle-crus approach after the the pre-operative examinations were finished. Results The average operating time was 53 minutes(range, 41-67 minutes), the blood loss was 27 ml (range, 13-35 ml). Postoperative complications such as infection, embolism, osteofascial compartment syndrome, nail loosing and nonunion were not occurred. The patients were followed up regularly with a mean time of 20 months(range, 16-24 months). The mean time of union was 8.5 months(range, 5-16 months). The scores in Lysholm knee system ranged from 86-98 (93.1±3.7) points; The scores of ankle-hindfoot system in American Orthopaedic Foot And Ankle Society (AOFAS) ranged from 84-99 (92.0±4.6) points. Conclusions Autologous bone grafting is effective on atrophic nonunion caused by open tibia fractures with external fixation. Key words: Autologous bone grafting; Open tibia fractures; Atrophic nonunion; External fixation; Treatment