24 patients with distal tibia fractures who underwent operative fixation were included in this trial to determine the safety and efficacy of a minimally invasive intervention through the percutaneous introduction of an aspirated bone marrow enriched Mesenchymal stem cell (MSC) graft in regards to union time, pain and quality of life. Included patients were randomized to the control group (no additional treatment) or the intervention, a prophylactic treatment consisting of a MSC composite graft 3 to 6 weeks after their initial operation. Results demonstrated a reduced time for union in the MSC composite graft group. No patients experienced nonunions in either group over the 12 month follow-up, but 3 patients in the control group experienced delayed unions. Pain and quality of life were equivalent between the two interventions. It should be noted that this pilot study was limited by the small sample size and the fact that it took place in a single-center.