PROGNOSTIC INDICATORS IN BONE-GRAFTING FO R LOWER LEG FRACTURES

Records of 97 patients who had undergone a total of 171 cancellous bon e grafting procedures from 1971 to 1988 were analysed with respect to promotion of bony healing. It was found that 50 patients had undergone 1 grafting procedure each in the tibia, while 47 patients had each un dergone 2-5 bone grafting procedures. Therefore only every second proc edure at best could be considered as successful. Predictors for unsucc essful grafting were found to be large bone defects, poor vascularizat ion and, especially, infection. Primary grafting was related to more p roblems in terms of uneventful bone healing than was ''postprimary'' g rafting after 3 and more weeks after accident. We therefore recommend delayed grafting in cases of fractures with soft tissue ruptures. In a ll cases of segmental bone loss multiple bone grafting procedures shou ld now be carefully compared with the advantages of segmental bone tra nsport techniques.