[Personal experiences in the reconstruction of trauma-induced bone defects]

In this report an analysis of all patients treated with bone grafting in a 5-year period is given. Bone grafting was necessary in 8.4% of patients treated by osteosynthesis. Bone defects are seen mostly in the lower extremities. Malunion and nonunion are relatively frequent after fractures of the forearm and tibia. Contaminated fractures were seen in 32 patients. Before any osseous reconstruction, the defects of skin and soft tissues had to be closed and local infections treated. The period between accident and bone grafting ranged between 3 weeks and 1 1/2 years. Only in stage I fractures is primary grafting indicated. Intensive treatment of infection was required first in 16.9% of cases. When segmental defects are present, multistaged bone grafting entails only a low degree of risk and usually successful. In 87% autogenic cancellous iliac bone was transplanted. The use of allogenic spongiosa cannot be recommended for traumatic defects.