Further observations on the fate of pedicle osteocutaneous grafts

Recent work has shown that pedicle osteocutaneous grafts retain their viability and participate actively in the restructuring of transferred bone. The present study investigates two aspects of this process: (1) whether or not healthy recipient bone is needed for the survival of these grafts and (2) the degree of periosteal involvement in osteogenesis. Six adult dogs were used. Pedicle osteocutaneous grafts were constructed using the anterior table of the frontal sinus. Rotation of these flaps allowed implantation of the bone transplant into the ipsilateral parietal muscle. Free bone grafts were used as controls and were implanted in the contralateral muscle. Specimens were removed at variable intervals between 8 and 40 weeks after operation. All free grafts were reabsorbed. Pedicle-assisted bone grafts retained their volume and exhibited marked periosteal osteogenesis that eventually produced enough new bone to replace the graft. These experiments provide strong evidence that bone restructuring in osteocutaneous grafts may be independent of recipient bone and that it depends almost exclusively on periosteal activity.