[Reconstruction of tangential and circular infected bone defects]

In the treatment of bone infections the reconstruction and rehabilitation of bone defects is a problem that often requires treatment secondary to curative treatment of the infection. For the reconstruction of smaller and more extensive defects we used predominantly (92.7%) autogenous (autologous) untreated spongiosa and in only 7% of the cases allogenic (homologous) spongiosa from an organ bank, this being added if necessary. Recently the additionally introduced vascularized bone chip has become a useful extension of the therapy concept. The problems and complications of defect reconstruction are demonstrated for 705 cases of bone infection with 472 defects of different sizes, based on a comprehensive classification with defect calculation. Surgical technical approach and special aspects of after-treatment are described, as well as the results for every group of cases. We achieved stability and freedom from infection in a total of 93.7% of the patients. As was to be expected, the problems grow with the size of the defect. Particularly problematic are joint infections with adjacent extensive circular defect.