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Semiopen cancellous bone grafting. A 2 step method for closing small infected tibial bone defects
1Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Taiwan, Republic of China.
Clinical Orthopaedics and Related Research
|September 1, 1994
Summary
This study presents a two-stage treatment for infected tibial bone defects, successfully healing bone and skin without additional grafts. This method offers an effective alternative to traditional treatments, reducing hospitalization and morbidity.
Area of Science:
- Orthopedic Surgery
- Regenerative Medicine
- Infectious Disease Management
Background:
- Infected tibial bone defects with overlying skin loss present a significant clinical challenge.
- Traditional treatments like free tissue transfer or the Papineau method can involve prolonged hospitalization and morbidity.
Purpose of the Study:
- To evaluate a two-stage surgical procedure for treating infected small tibial bone defects with overlying skin loss.
- To assess the efficacy and outcomes of this novel approach in promoting bone union and wound healing.
Main Methods:
- A two-stage surgical approach was employed, utilizing antibiotic-impregnated polymethylmethacrylate bead chains in the first stage for debridement and temporary coverage with porcine skin grafts.
- The second stage involved replacing bead chains with autogenous cancellous bone graft and repeat porcine skin grafting.
Main Results:
- All thirteen patients achieved wound and bone graft healing without requiring additional autogenous grafts.
- Average hospitalization was 23 days, with bone union achieved in an average of 6.4 months.
- No recurrence of osteomyelitis was observed during an average follow-up of 37 months.
Conclusions:
- The described two-stage procedure effectively manages infected tibial bone defects with small skin losses.
- This method avoids prolonged hospitalization and the morbidity associated with free tissue transfer or the Papineau technique.