The use of periosteally vascularized autografts to augment the fixation of large segmental allografts

Large segmental bone grafts are a standard of reconstructing long bone defects. Nonunion or delayed union at the host-graft junction is a major complication of these procedures. In six patients, a nonunion was treated by locally available bone, vascularized by its periosteum as an onlay autograft to improve fixation and speed incorporation of the allograft into the host bone. At three months, all were pain free and using their allografts without limitation. By four months, all had roentgenographic evidence of allograft and autograft incorporation. During the follow-up period from two to four years, all have incorporated the allografts and are pain free.