In most fractures, ossification may not occur or may be incomplete. In such cases, surgery is required, a bone transplant is required. But from where and how?
One of the most exciting areas of bone surgery is bone grafting, which is used to replace deficiencies that have arisen for various reasons. But what causes this condition, which can occur in both the spongy and cortical parts of the bone tissue? Most often, as a result of an accident, in which case a cavity is left between the highlighted bone parts that have been adjusted to their place, behind them during the compacted fracture of the spongy tissue.
• In the cortical bone stock, there is a deficiency mainly in the case of fragmentary or open fractures, when some pieces may die or be ejected.
• Cancers can also cause a similar problem. Whatever the origin of the bone deficiency, the body tries to fill it on its own, which is also sufficient in the case of a smaller extent. Since the spontaneous filling of larger cavities would be limited and prolonged in time, artificial bone replacement is usually necessary. Biologically it is most preferable to use your own bonebut in more extensive cases, another solution is also discussed. When transplanting, in addition to the quality of the transplanted bone, it is also important to have a good blood supply to the receiving site, because this is the only way to hope for complete integration. It is essential that the transplanted bone is stably fixed. The most common is the transplantation of cancellous bone, which is usually obtained from the hip blade. If an increase in mechanical stability is also required, so-called corticospongiosus a block must be taken out, in which case the spongy material also includes a harder piece of bone cortex. A smaller amount of cancellous bone can be obtained from the head of the tibia, the wrist end of the spindle bone, or the elbow end of the ulna. In some cases, the transplant is carried out immediately during the first treatment, e.g. to fill the cavity formed as a result of crowding in the case of an impression fracture of the tibial head. Secondary transplantation is used to treat protracted fracture healing and false joints. If your own bone is not enough, you can call on the bone bank, where human bone products are available, which are usually made from the femur heads removed during hip replacement surgeries.
Dr. György Boross
orthopedist, hand surgeon, accident surgeon
drboross@drboross.com
www.drboross.com
The article was published in Patika Magazin Rejtvényújság.
October 2024
Source: www.patikamagazin.hu
