Abstract
BackgroundThe aims of this study were to discuss the principle, therapeutic effect and influencing factors of multiple wrapped cancellous bone graft methods for treatment of segmental bone defects.MethodsThis study retrospectively analyzed the therapeutic effect of different wrapped autologous cancellous bone graft techniques on 51 patients aged (34.5 ± 11.5) years with segmental bone defects. Cancellous bones were wrapped with titanium mesh (n = 9), line mesh (n = 10), line suturing or line binding cortical block, (n = 13), or induced membrane (n = 19). The bone defeats were as follows: tibia (n = 23), radial bone (n = 10), humerus (n = 8), ulnar bone (n = 7), and femur (n = 3). The defect lengths were (5.9 ± 1.1) cm. The functionary recovery of adjacent joint was evaluated by the Paley‘s method and DASH, respectively.ResultsThe incision healed by first intention in 48 cases and secondary healing in 3 cases. All patients were followed up for 19.1 ± 7.1 (12–48) months. Other than one patient with nonunion who received a secondary bone graft, all the patients were first intention of bone healing (the healing rate was 98.0%). The healing time was 6.1 ± 2.1 (3–15) months. There were no significant differences in the healing time among the 4 groups (χ2 = 1.864, P = 0.601). The incidence of complications in the grafted site was 11.8%, whereas it was 21.6% in the harvest site. At the last follow-up, all the patients had recovered and were able to engage in weight-bearing activities. The functional recovery was good to excellent in 78.4% of cases, there were no significant difference among the 4 groups (χ2 = 5.429, P = 0.143).ConclusionsWrapped cancellous bone grafting is a modified free bone graft method that can be used in the treatment of small and large segmental bone defects as it prevents loosening and bone absorption after bone grafting. The effect of bone healing is related with the quality and quantity of grafted bone, stability of bone defects, property of wrapping material and peripheral blood supply.
Highlights
The aims of this study were to discuss the principle, therapeutic effect and influencing factors of multiple wrapped cancellous bone graft methods for treatment of segmental bone defects
We investigate the principle, therapeutic effect and influencing factors of wrapped cancellous bone graft for bone defects
There were no significant differences in surgical incision healing times among the four groups
Summary
The aims of this study were to discuss the principle, therapeutic effect and influencing factors of multiple wrapped cancellous bone graft methods for treatment of segmental bone defects. Bone defects, which are commonly induced by bone infection, removal of bone tumors, and severe trauma, account for 15% of fractures of limbs and cause a decline in the quality of life of patients. Bone defects longer than 2 cm will not heal by themselves and need to be repaired. A free bone graft is the “gold standard” for the. Ma et al BMC Musculoskeletal Disorders (2019) 20:346 times, and a high incidence of complications, such as joint stiffness, infection, and loosening of the nail path. Vascularized bone grafting requires microsurgical techniques, which result in difficult to be popularized. The shortcomings of large allogeneic bone grafts include slow healing time, high rates of refractures and infections, and foreign body reactions, all of which restrict its widespread application. Tissue engineering techniques are an option but are only in the experimental research stage [5, 6]
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