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Osteomyoperiosteal Decortication Supplemented by Bony Transplants in the Treatment of Primarily Created Bony Defects of the Forearm Bones in Patients After Forearm Replantation

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Jabłecki J., Kaczmarzyk L., Domanasiewicz A., Kaczmapzyk J.
Polish Journal of Surgery
|
2008
|
vol. 80
|
issue 2
69-74
EN
Amputation-type mutilation of forearm caused by crush or explosion mechanism result in bone defects of different size, which after successful replantation require filling by secondary reconstructive procedures.The aim of the study was presentation of the results of filling these defect by means oste-musculoperiosteal decortication with supplementation of cortico - canceleous bony transplants.Material and methods. From Jan. 1993 till Oct. 2006 14 men (mean age 31.3 y) were operated on for bone defects after 15.8 weeks on average. Defects of average size of 3.2 cm (range: 1.5 - 10 cm) were localized in shafts of forearm bones: radial bone (n=7), ulnar bone (n=4), both of the bones (n=3). The patients were free of any inflammatory process within the forearm. All patients had the osteosynthesis made by Rush pins (in 4 patients the previously made unstable osteosynthesis was removed and rush pins were inserted). Osteo-musculo-periosteal decortication of bony shafts was followed by implementation of bony transplants in subperiosteal space. These were bridging the defect. After operations the plaster cast was applied for 10.2 weeks on average.Results. X-ray control performed every 6 - weeks enabled the assessment of evolution of bony union within the defects. The final control was made 12 months after the operation. Healing of all of the wounds was uncomplicated. One patient was reoperated because of resorbtion of the bony transplants, but a proper bony union was achieved finaly after 15 weeks. In all of the other 13 patients the unification was achieved after 15.4 weeks on average (range from 14-18 weeks).Conclusion. Osteo-musculo-periosteal decortication is an effective method of filling the bony defects in patients after replantation of forearm.
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