A REVIEW OF CURRENT CONCEPTS IN THE MANAGEMENT OF BONE DEFECTS IN TRAUMA AND ORTHOPAEDICS

Area of Science:

• Orthopaedic Surgery
• Regenerative Medicine
• Biomaterials Science

Background:

• Segmental bone defects pose significant challenges in trauma and orthopaedic surgery, often resulting from high-energy trauma, tumor resection, infection, or non-union.
• These defects are frequently complicated by soft tissue loss and patient comorbidities, necessitating complex reconstructive approaches.

Purpose of the Study:

• To review current and emerging techniques for managing segmental bone defects.
• To emphasize the importance of host optimization, soft tissue management, and multidisciplinary collaboration in achieving successful reconstructive outcomes.

Main Methods:

• Synthesis of current concepts in bone defect management, including established and novel techniques.
• Evaluation of reconstructive strategies such as autologous grafting, allografts, distraction osteogenesis, and the Masquelet technique.
• Consideration of emerging technologies like biologics, synthetic bone substitutes, and 3D printing.

Main Results:

• A wide array of reconstructive options exists, with treatment selection guided by defect characteristics and patient factors.
• While traditional methods are vital, advancements in biologics and 3D printing offer future potential but require further evaluation.
• Complications such as infection and graft failure remain significant challenges in bone defect management.

Conclusions:

• Successful management of segmental bone defects relies on a combination of appropriate surgical techniques, host optimization, and timely soft tissue reconstruction.
• Multidisciplinary collaboration is essential for comprehensive patient care.
• Future advancements necessitate robust clinical trials and patient-reported outcome measures to refine treatment strategies.