A Comparison Between Lateral and Medial Proximal Tibial Grafting

OBJECTIVE: Autologous bone is accepted as the gold standard graft material for oral defects . The lateral proximal tibial approach via the Gerdy’s tubercle has been widely used , which is situated close to important anatomical structures that if violated , could cause permanent disability . We proposed a modified medial approach over the tibial plateau with better access to the proximal tibia for harvesting of autogenous bone . A comparison of post – operative patient acceptance and complications were done . METHODS: A sample of ten patients who had both tibias harvested , the right tibia via the Gerdy’s tubercle and the left tibia via the medial approach . Post-operative complications were noted in each leg and the patients were questioned using a questionnaire about their subjective opinion regarding the two approaches . RESULTS: The modified medial approach was found to have fewer post –operative complications and almost all the patients felt less pain and problems with ambulation . Intra –operatively the modified medial approach is an easier surgical procedure with no important anatomical structures that can be injured . CONCLUSION: The modified medial approach offers a safer surgical grafting site for autogenous bone with less post –operative complications and most patients favoured the modified medial approach .