[Prognosis of spongiosa-plasty of the fractured tibial shaft].

Records of 97 patients who had undergone a total of 171 cancellous bone 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 undergone 2-5 bone grafting procedures. Therefore only every second procedure at best could be considered as successful. Predictors for unsuccessful grafting were found to be large bone defects, poor vascularization and, especially, infection. Primary grafting was related to more problems in terms of uneventful bone healing than was "postprimary" grafting after 3 and more weeks after accident. We therefore recommend delayed grafting in cases of fractures with soft tissue ruptures. In all cases of segmental bone loss multiple bone grafting procedures should now be carefully compared with the advantages of segmental bone transport techniques.