Abstract
Aim: To evaluate the technique of percutaneously harvested bone graft mixed with morphogenic bone protein and endoscopically delivered to ununited long bone fractures.
Methods: Thirty-eight patients with established delayed union of long bone fractures were bone-grafted endoscopically. Morphogenic bone protein (OP1) was used in 12 cases and the graft was supplemented with calcium sulphate pellets (Osteoset). The minimum follow-up was eight months. The study group included eight femoral shaft fractures, two humeral shaft fractures and the remainder were tibial shaft fractures.
Results: Four fractures failed to unite with this technique. Two femoral shaft non-unions required repeat surgery, one humeral shaft non-union and one tibial shaft non-union required supplementary grafting and fixation. The technique requires radiological imaging to supplement endoscopic preparation and graft delivery. For tibial fractures this can be used as a day-stay technique but most patients required one night in hospital.
Conclusions: Endoscopic bone grafting can be supplemented with graft substitute (Osteoset) and morphogenic protein (OP1). It is as effective as standard open ‘onlay’ grafting but good fixation of the fracture is necessary before graft and supplements are effective.
The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand
