Clinical Analysis Of 68 Cases' Bone Defect Of Long Bones

Objective To have a retrospective analysis of 68 cases ofbone defect of limbs'long bones from March 2000 to March 2006 ofour hospital, 55 cases for auto-bone grafting,12 cases for prostheticreplacement, 1 case for homogeneity-variant bone grafting. Inducethe cause of the bone defect, and estimate the significance of abovethree therapies in bone defect, to direct us use the best reasonableapproach to healing the limbs' bone defect.Methods summarize the 68 clinical cases, 42 are males, 16are females;from 1 to 67age. 35.8 mean age. 45 external injury causethe bone defect : 25 cases by road accidenct;14 cases by heavy masscrashed;6 cases by hit. the rest 23 cases are caused by tumor: 6 casesby benign tumor;10 cases by giant cell tumor of bone;7cases bymalignant tumor(include metastatic carcinoma). through the analysisof the therapies for the above cases, evaluate the difference of autobone grafting,prosthetic replacement and homogeneity -variant bonegrafting..Results all of the operative incisiones are primary healing.2-60months follow-up. 24.8 months average. There were 49 casesbone healing only by 1 operation in all of the 55 cases of theauto-bone grafting group. 5 cases healing by one more operation, 1case disunion. Joint –motion function in accordance with Ennekingevaluation criterion: 32 cases are best;19 cases are better,12 casesare okay, 2 cases are bad. In all the 12 cases of the metastaticcarcinoma group, 1 case died because of the malignant tumoraggravated;1 case had been amputated for the malignant tumorrecur.the rest survival 10 cases'joint-motion function in accordancewith Enneking evaluation criterion: 8 cases are best, 1 is better,1 isgood. As for the only 1 child whom has been operate byhomogeneity-variant bone grafting.Conclusion The causes of bone defect are clear usually, butthere are some difficult in therapy. There are many ways to recoverythe defect and functional reconstruction, but the auto-bone grafting(auto-bone free grafting and the bone with angei-pedicel grafting)is the most general way for clinical application. Homogeneity-variant bone grafting, prosthetic replacement, bone's substitutematerial and bone growth factor, bone tissue engineering,Membrane Guided Tissue Regeneration, all of above have make agreat rapid progress .auto-bone has better bone formation activitythan the others, it wont has trouble in immunology and can beutilized by the body. Auto-bone grafting will take shorter time forcrawl substitute and there will be less bleed in operation. This wholeclinical practice has prove it is important that make a combinedtherapy for the bone defect, the homogeneity-variant bone and theother artificial bone can be the addition for the chunk bone grafting.The auto iliac bone marrow will increase the chance of healing as theseed-cell which has breed ability. What's more iliac crest corticalbone has certainly hardness, so it can filling the defect and be abracket. So iliac is an ideal part to be take. The artificial joint is alsorefer to the bone defect where happened near the joint. As for the bigsection of long bone defect, it mostly formed after the amputation formalignant tumor .