Comparison of mini-open reduction and autologous bone grafting with closed reduction and intramedullary device insertion for tibial shaft fractures: a retrospective study

BACKGROUND: We compared the clinical efficacy of mini-open reduction and autologous bone grafting (G(M)) and closed reduction (G(C)) using intramedullary nailing for the treatment of tibial shaft fractures. METHODS: This retrospective study included 70 tibial shaft fractures treated with G(M) or G(C) between January 2018 and December 2021. The demographic characteristics and clinical outcomes were compared between the two treatment methods. RESULTS: This study included 70 patients who were followed-up for 12.4 months. In total, 31 and 39 patients were treated with G(M) and G(C), respectively. The operative duration was significantly shorter for G(M) (95.2 ± 19.3 min) than for G(C) (105.5 ± 22.2 min, p = 0.0454). The number of radiation times was significantly lower for G(M) (14.7 ± 6.3) than for G(C) (22.2 ± 9.2, p < 0.005). There were no statistically significant differences between the groups in terms of the wound complication or infection rates. The malunion and nonunion rates were high after G(C) than after G(M), but there are no significant differences between the groups. CONCLUSIONS: Closed reduction and intramedullary nailing remains the first choice for tibial shaft fractures. G(M) is a safe and effective treatment worth considering. Future prospective randomized controlled trials are warranted.