Engelhardt P, Velasco R
Klinik für Orthopädische Chirurgie, Kantonsspital St. Gallen.
Unfallchirurg. 1994 Oct;97(10):525-9.
Records of 97 patients who had undergone a total of 171 cancellous bone grafting procedures from 1971 to 1988 were analysed with respect to promotion of bony healing. It was found that 50 patients had undergone 1 grafting procedure each in the tibia, while 47 patients had each undergone 2-5 bone grafting procedures. Therefore only every second procedure at best could be considered as successful. Predictors for unsuccessful grafting were found to be large bone defects, poor vascularization and, especially, infection. Primary grafting was related to more problems in terms of uneventful bone healing than was "postprimary" grafting after 3 and more weeks after accident. We therefore recommend delayed grafting in cases of fractures with soft tissue ruptures. In all cases of segmental bone loss multiple bone grafting procedures should now be carefully compared with the advantages of segmental bone transport techniques.
分析了1971年至1988年间共接受171次松质骨移植手术的97例患者促进骨愈合的记录。发现50例患者在胫骨各接受了1次移植手术，而47例患者各接受了2至5次骨移植手术。因此，充其量只有每第二次手术可被视为成功。发现移植失败的预测因素包括大的骨缺损、血管化不良，尤其是感染。与事故后3周及更长时间的“初次后”移植相比，初次移植在顺利骨愈合方面存在更多问题。因此，我们建议在伴有软组织破裂的骨折病例中延迟移植。在所有节段性骨丢失的病例中，现在应仔细比较多次骨移植手术与节段性骨搬运技术的优势。
