superficial bone graft

The treatment of non-union of long bone fractures includes bone grafting, internal fixation, external fixation, pedicle bone grafting, blood vessel or periosteal transplantation. In addition, electrical stimulation treatment of fracture nonunion also promotes bone healing, with a success rate of 80% to 85%. There are no definite rules for the choice of surgical methods, but the type of fracture nonunion, local soft tissue conditions, previously treated treatment, and whether there is an infection or a previous infection have to be considered. If the affected limb is accompanied by a significant shortening, the limb must be extended at the same time to improve the walking function of the lower limb. Surgical treatment of fracture nonunion, it is generally believed that the removal of fibrous scar tissue between the ends of the fracture, trimming the fracture end and cutting the medullary cavity of the atresia, is conducive to revascularization and bone healing at the fracture end. Due to the increasing understanding of biomechanical factors in promoting bone healing, many clinical observations in recent years have shown that the hardened fracture end is not a dead bone, but a type of proliferative response that does not heal a fracture. This type of non-healing fracture does not require resection of the hardened bone. The fibrous tissue between the end and the end of the fracture does not need to be bone grafted, but only the solid internal fixation or external fixation can rapidly transform the nonunion tissue between the fracture ends into bone tissue, and the non-healing fracture is transformed into healing. Therefore, these scholars do not advocate the re-construction of bone ends and bone grafts as a routine surgical procedure for the treatment of non-unsaturated fractures, but emphasize the firm fixation of the broken ends of the bones and the axial compression stress stimulation at the fracture ends as the main conditions for bone healing. . Osteopathy is still often chosen as a more reliable method to promote bone healing. Non-reactive atrophic non-union fractures, in addition to the need for stable fixation, it is generally advocated for the implementation of cortical osteotomy and bone grafting. Resection of the sclerosing fracture end will result in a fracture end gap or defect, and it is often necessary to use the embedded bone graft to maintain the continuity of the fracture end and to compensate for the shortening of the limb caused by the removal of the bone. Autologous cancellous bone grafting has the best osteogenesis effect, and cortical bone can also be added to increase support. Allogeneic bone can be used when the autogenous bone is insufficient. Simple allogeneic bone transplantation, due to immune rejection, still has a 20% failure rate. Allogeneic bone plus autologous red bone marrow and/or bone morphogenetic protein (BMP) composite transplantation can improve the success of allogeneic bone transplantation. Rate, which is mainly used to treat bone defects. Commonly used bone grafting methods for the treatment of fractures that are definitely not healed are bone grafting around the fracture end and extensive cortical bone stripping, as well as maxillary bone grafting, embedded bone grafting and gliding bone grafting. Treatment of diseases: humeral shaft fractures Cut off the humerus The 4~5cm incision is made with the center of the dislocation healing center or the anterior and lateral part of the lower leg. The tibia is exposed between the longus and short muscles of the soleus muscle and the tibia, and the tibia is cut and removed 1 to 2 cm to eliminate the supporting effect that is not conducive to the healing of the tibia. 2. Reveal the humeral fracture Centering on the nonunion of the humerus, the end of the bone is revealed by an arc or longitudinal incision. Cut the periosteum of both sides of the bone, but do not peel extensively, generally not more than half of the circumference of the humerus. Pay attention to the blood vessels that protect the surrounding soft tissue and periosteum. 3. Treatment of the bone surface Use a bone knife to cut the high convex part of the bone surface and a thin layer of cortical bone. The length of the bone surface at both ends of the fracture was about 10 cm, so that the bone was placed flat. Fibrosis and cartilage osteophytes between the ends of the bone are not removed. 4. Bone graft Cut the rectangular bone plate from the humerus or humerus, and trim it so that it can be placed flat on the surface of the tibia affected by the thin cortical bone. Use the rongeur to clamp the upper and lower ends of the fracture and the bone block. Use the bone drill to drill the bone and cortex on both sides of the humerus, and then fix it with 4-6 screws to tightly implant a large amount of cancellous bone. 5. Stitching and fixing Stop bleeding after releasing the tourniquet. Rinse the wound. Suture the periosteum and soft tissue. Stitch the skin incision. Wrap the long leg tubular plaster to the bone to heal.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.