THE BRIDGING OF BONE DEFECTS

Abstract

Bone-grafting operations, for defects and non-union of the bones of the extremities, were performed on 105 patients at Deer Lodge Hospital between April 15, 1944, and April 15, 1946. Union has occurred in ninety-three cases. Penicillin was used routinely after every operation, and no graft was lost or failed to unite because of primary wound infection. In eighty-four cases, or 80 per cent., the first graft was successful. The cortical onlay graft was use twenty-nine times for twenty-seven patients, and resulted in union in twenty-three, or 79 per cent, of the cases. The cortical inlay graft was used twenty-seven times for twenty-five patients, and was successful in twenty-two, or 81 per cent. Cancellous bone alone was used to fill gaps, or to promote union in ununited fractures, twenty-three times for twenty-three cases; union occurred in twenty, or 87 per cent. Combined with a metal plate, it was used thirteen times on thirteen patients, with union in nine, or 69 per cent. It was used nine times in incomplete defects of the shaft of the long bones, and fused with the shaft in seven, or 78 per cent. Cancellous bone alone was used to fill infected bone cavities, with discharging sinuses, in twelve cases. Wound healing occurred in nine cases.