Transplantation of vascularized bone grafts for treatment of bone pseudoarthroses and defects

Abstract

Introduction. Pseudoarthroses and defects of limb bones occur in 0.5-27% as a complication of fracture treatment. Recently, much attention is paid to the treatment techniques using non-free vascularized bone grafts, however, there are very few publications relating to the techniques of graft formation and transplantation.
Purpose. To study the results of surgical treatment of patients with bone pseudoarthroses and defects using non-free vascularized bone grafts.
Materials and Methods. An experimental study of 73 cadavers performed in order to investigate the donor zones. The analysis of treatment of 135 patients using such grafts made in the work. The results of treatment estimated according to DASH Questionnaire (Disabilities of the Arm, Shoulder, and Hand Questionnaire).
Results. Unions achieved in 130 operated patients. There were the following causes of failure: early stoppage of immobilization, repeated trauma, and osteomyelitis of the transplanted bone graft.
Conclusion. The analysis of the experimental studies made it possible to identify the donor zones for forming the non-free vascularized bone grafts and their transplanting into the area of bone pseudoarthrosis or defect. The use of the developed techniques of transplanting the non-free vascularized bone grafts resulted in filling bone defects and consolidating pseudoarthroses in 130 (96.3%) of 135 operated patients.