BONE DEFECTS

What is a bone defect?

• A bone defect is when part of bone is lost, typically from trauma or infecton

 

What are the types of bone defect?

• Partial - a bone defect where there is a portion of bone missing but there is still some contact between the remaining bone ends

• Segmental - a bone defect where there is a portion of bone missing but there is no contact between the the remaining bone ends

 

Are all partial bone defects the same?

• Partial bone defects can be considered critical or non-critical 

• Critical - the remaining bone when healed  support the function of the limb, even with the piece of bone missing

 

What are the techniques for managing bone defects

• Grafting - synthetic materials or patients bone bone from elsewhere in the body - typically used for non-critical partial bone defects

• Masquelet - the induced membrane technique - a two step surgical procedure:

  • Creating a membrane around a cement spacer (induced membrane)

  • At a later date using that membrane to promote bone growth when the spacer is replaced with a bone graft. 

• Bone transport - distraction osteogenesis - a piece of bone from the affected bone is moved up or down to replace the missing piece, whilst new bone grows to replace where it came from

• Shortening with lengthening

  • Bringing two pieces of bone together to eliminate the defect and lengthening the same limb elsewhere to ensure it stays and equal length