Role of formalin-preserved allograft in fresh fractures with comminution

The use of bone grafting in polytrauma patients is associated with significant problems. Additional surgical time is required for the use of cancellous autografts, and there may be a significant incidence of donor site morbidity. Various types of allografts used in western countries are expensive to obtain and store, and the technical know-how required for their use may not be available in Third World countries. A series is reported in which formalin-preserved allograft (FPA) was used for the management of comminuted fractures in 22 polytrauma cases. This type of allograft is inexpensive, easy to prepare and store, and has been shown in experimental and clinical studies to be nonantigenic and sterile. The complication rate and time to union were comparable with a control series of autografted cases and previously reported series in the literature. Based on the results in this series of patients, the use of FPA is recommended for the grafting of multiple fractures, especially when other forms of allograft are not available because of technical or financial limitations.