BONE GRAFTING Edited by Alessandro Zorzi and João Batista de Miranda Bone Grafting Edited by Alessandro Zorzi and João Batista de Miranda Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Jana Sertic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Bone Grafting, Edited by Alessandro Zorzi and João Batista de Miranda p. cm. ISBN 978-953-51-0324-0 Contents Preface IX Part 1 Introduction 1 Chapter 1 Introduction 3 Alessandro Rozim Zorzi and João Batista de Miranda Chapter 2 Basic Knowledge of Bone Grafting 11 Nguyen Ngoc Hung Part 2 Basic Science 39 Chapter 3 Influence of Freeze-Drying and Irradiation on Mechanical Properties of Human Cancellous Bone: Application to Impaction Bone Grafting 41 Olivier Cornu Part 3 Trauma Surgery 59 Chapter 4 Bone Grafting in Malunited Fractures 61 Fernando Baldy dos Reis and Jean Klay Santos Machado Chapter 5 Reconstruction of Post-Traumatic Bone Defect of the Upper-Limb with Vascularized Fibular Graft 75 R. Adani, L. Tarallo and R. Mugnai Part 4 Orthopaedic Surgery 89 Chapter 6 Congenital Pseudarthrosis of the Tibia: Combined Pharmacologic and Surgical Treatment Using Biphosphonate Intravenous Infusion and Bone Morphogenic Protein with Periosteal and Cancellous Autogenous Bone Grafting, Tibio-Fibular Cross Union, Intramedullary Rodding and External Fixation 91 Dror Paley VI Contents Chapter 7 Osteonecrosis Femoral Head Treatment by Core Decompression and ILIAC CREST-TFL Muscle Pedicle Grafting 107 Sudhir Babhulkar Chapter 8 Treatment of Distal Radius Bone Defects with Injectable Calcium Sulphate Cement 125 Deng Lei, Ma Zhanzhong, Yang Huaikuo, Xue Lei and Yang Gongbo Chapter 9 Spinal Fusion with Methylmethacrylate Cage 135 Majid Reza Farrokhi and Golnaz Yadollahi Khales Chapter 10 Treatment of Chronic Osteomyelitis Using Vancomycin-Impregnated Calcium Sulphate Cement 147 Deng Lei, Ma Zhanzhong, Yang Huaikuo, Xue Lei, Yang Gongbo Part 5 Oral and Maxillofacial Surgery 157 Chapter 11 To Graft or Not to Graft? Evidence-Based Guide to Decision Making in Oral Bone Graft Surgery 159 Bernhard Pommer, Werner Zechner, Georg Watzek and Richard Palmer Chapter 12 Clinical Concepts in Oral and Maxillofacial Surgery and Novel Findings to the Field of Bone Regeneration 183 Annika Rosén and Rachael Sugars Preface It was a great pleasure to receive the invitation to coordinate the edition of a book devoted to bone grafting surgery from InTech. Bone is the second most frequently transplanted tissue in the human body, after blood. Nearly one million bone graft procedures are performed worldwide each year. Although autologous bone graft remains the gold standard procedure, the pursuit of substitutes, to avoid clinical morbidity, is one of the greatest fields of research nowadays. The initial proposal offered to us, presented the project of an open access book, directed to a broad audience, formed by researchers, students and clinical practitioners. This project caught our attention because of two important reasons. First, because the breadth of the subject, constituted by bone grafts and bone grafts substitutes, causes it to be partially addressed in isolated chapters inserted in textbooks of different fields, such as orthopedics, neurosurgery, plastic surgery and dentistry. There are only few textbooks focusing specifically the theme, frequently printed editions which are often difficult to acquire. This is the second reason that makes this project so interesting. Also, as an open access online book, it is available everywhere around the world. In addition to allow worldwide reading, this book also has the advantage to put together authors from different continents, with different point of views and different experiences with bone grafting. Leading researchers of Asia, America and European countries contributed as authors. In this book, reader can find chapters from basic principles intended to students, to research results and description of new techniques from which experts can benefit a great deal. We wish to thank the authors, which contributed with their time and wisdom, to make this project possible. We wish to thank specially the InTech Publishing Process Managers, Jana Sertic and Ivana Zec, for their help and support. Alessandro Rozim Zorzi, MD, MSc Orthopedics and Traumatology Department, Campinas State University (UNICAMP), Brazil João Batista de Miranda, MD, PhD Orthopedics and Traumatology Department, Campinas State University (UNICAMP), Brazil [...]...Part 1 Introduction 1 Introduction Alessandro Rozim Zorzi and João Batista de Miranda Campinas State University - UNICAMP, Brazil Bone grafting represents an exciting field of study and a major advance of modern surgery It is an important tool that allows surgeons to deal with different and difficult situations Massive tissue loss or impaired bone healing, caused by tumors, trauma, infections or congenital... unsolved problems until the recent development of bone grafting one century ago Bone graft could be defined as a bone fragment transplanted, whole or in pieces, from one site to another Bone grafting is the name of the surgical procedure, by which bone graft, or a bone graft substitute, is placed into fractures or bone defects, to aid in healing or to improve strength Bone is the second most commonly... He believed that transplanted bone was invaded by vascular granulation tissue, causing the old bone to be resorbed and subsequently replaced by the host with new bone Phemister's concept remains valid; however, Abbott and associates have shown that, in addition, surface cells in the bone graft survive and participate in new bone formation [3] Ray and Sabet [4] and Arora and Laskin [5] also confirmed... available, and its use is not recommended Cancellous Bone Substitutes Hydroxyapatite and tricalcium phosphate, synthetic and naturally occurring materials, are now being used as substitutes for cancellous bone grafts in certain circumstances These porous materials are invaded by blood vessels and osteogenic cells, provide a scaffold for new bone formation, and are, in theory, eventually replaced by bone. .. reconstruct the umerus of a child with a cadaveric bone Barth and Marchand also observed that the bone from autograft, when transplanted to another site, goes to necrosis and are subsequently invaded by host cells that differentiate to bone cells and produce new bone In that way, those authors demonstrated that a fragment of bone take from one site can substitute bone from another site The French surgeon Léopold... the transmission of HIV and other diseases; tissue typing and the use of immunosuppressants are being tried; autologous bone marrow is being added to autogenous and homogenous bone grafts to stimulate osteogenesis; and bone graft substitutes have been developed Bone graft are involved in successful bone graft include osteoconduction (guiding the reparative growth of the natural bone) , osteoinduction... in children Journal of Pediatric Orthopaedics B 2009; 18:79–85 [21]) 22 Bone Grafting 6 Practical bone grafting 6.1 Bone grafting fundamentals Bone grafting refers to a wide variety of surgical methods augmenting or stimulating the formation of new bone where it is needed There are five broad clinical situations in which bone grafting is performed: 1 2 3 4 5 To stimulate healing of fractures either... and techniques of bone grafting procedures were well established before "the metallurgic age" of orthopaedic surgery Because of the necessity of using autogenous materials such as bone pegs or, in some cases, using wire loops, fixation of grafts was rather crude Lane and Sandhu introduced internal fixation; Albee and Kushner, Henderson, Campbell, and others added osteogenesis to this principle to develop... of the biology of bone healing 4 Bone Grafting Although reports of autologous bone grafting date back to the ancient Egypt, the first description of systematic use of autologous bone grafting, with the modern principles and concepts, is attributed to Fred H Albee (1876 – 1945), a North American surgeon that served during the First World War, and published in 1915 a textbook named Bone Graft Surgery”... undifferentiated cells 12 Bone Grafting to become active osteoblast), and osteogenesis (living bone cells in the graft material contribute to become remodeling) Osteogenesis only occurs with autografts Bone grafts may be used for the following purposes: 1 2 3 4 5 6 7 To fill cavities or defects resulting from cysts, tumors, or other causes To bridge joints and thereby provide arthrodesis To bridge major defects or . BONE GRAFTING Edited by Alessandro Zorzi and João Batista de Miranda Bone Grafting Edited by Alessandro Zorzi and João Batista. copies can be obtained from orders@intechopen.com Bone Grafting, Edited by Alessandro Zorzi and João Batista de Miranda p. cm. ISBN 978-953-51-0324-0