Treatment of traumatic gap in long bones / 대한정형외과학회잡지

ABSTRACT

Recently there has been a noted increase in the incidence of traumatic bony gap in long bones due to accidents in industry, high speed traffic accidents and common gunshot accidents. There are several methods to treat traumatic bony gap such as bone graft (autogenous, homogenous and heterogenous), bone transplantation, periosteal osteogenesis and reinplantation of the extruded bone etc. The authors studied 26 patients of traumatic bony gap in the long bones which had been treated by autogenous bone grafting. The results of the clinical observation were as following; 1 The causes were shotgun accidents, vehicle accidennts and explosive accidents. 2 There was bony gap involved in 10 upper extremities and 16. lower extremities. The radius was the most common site in the upper extremity and the femur in the lower extremity. 3. The largest bony gaps were 10.5cm. in the tibia and next were 10.6cm. in ulna and 9.0cm. im humerus. 4. The period of the bony union in these cases was prolonged 1.5~3 times the usual healing period of simple fractures. 5. It was very important to prevent and control infection of the open fractures and to decide the correct time for bone grafting operation after healing of the infected wounds. We did the bone grafting sugery 2 or 3 months later after the infected wounds had been healed. 6 The authors could avoid some complications such as delayed union, shortening of the affected limbs and stiffness of the joints of the affected limbs etc.