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The open bone graft for septic nonunion.
Clinical Orthopaedics and Related Research
|November 1, 1983
Summary
This study treated septic nonunions using a two-stage protocol involving debridement and cancellous bone grafting. The method successfully healed most fractures, demonstrating an effective treatment for complex bone infections.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
- Bone Regeneration
Background:
- Septic nonunions present a significant challenge in orthopedic surgery.
- Actively draining septic nonunions require aggressive management to prevent further complications.
Purpose of the Study:
- To evaluate the efficacy of a two-stage surgical protocol for treating actively draining septic nonunions.
- To assess the outcomes of cancellous bone grafting in conjunction with external skeletal fixation.
Main Methods:
- A two-stage protocol was employed: debridement and external fixation, followed by autogenous cancellous bone grafting.
- External skeletal fixators were used for immobilization, averaging 7.5 months.
- Key technical considerations included ensuring granulation tissue coverage, biplanar fixation, and oversized grafts.
Main Results:
- Thirteen out of fifteen patients achieved fracture healing and remained infection-free.
- Two patients ultimately required amputation due to persistent infection or nonunion.
- The protocol demonstrated a high success rate in managing complex septic nonunions.
Conclusions:
- A two-stage protocol involving debridement, external fixation, and autogenous cancellous bone grafting is an effective treatment for septic nonunions.
- Careful adherence to technical details, such as graft size and granulation tissue coverage, is crucial for successful outcomes.
- This approach offers a viable limb salvage option for patients with challenging bone infections.