The "Clinical Practice Guidelines for Indications, Techniques, and Complications of Autologous Bone Grafting" was developed by the Trauma Orthopedic Branch of the Chinese Orthopedic Association and the National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation. Here is a detailed introduction in English:
Autologous bone grafts are used to repair bone defects caused by nonunion, infection, tumor resection, and spinal and joint fusion.
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According to the transplantation method
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Free bone grafting: The transplanted bone block has no blood supply. It acts as a scaffold in the bone grafting area. The cells cannot survive, and the vascular fibrous tissue of the recipient gradually absorbs it. The new blood vessels of the recipient bone bed grow in, and the osteoblasts entering the blood vessels produce new bone, forming new bone tissue, which is called "creeping substitution".
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Vascularized bone grafting: It is divided into pedicled and free grafts. A pedicled vascularized bone graft is transferred from the donor site to the recipient site with its original vasculature preserved. A free vascularized bone graft has its vascular pedicle divided, allowing it to be transferred to almost any location.
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According to the purpose of bone grafting
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Cortical bone grafting: Cortical bone is osteoconductive and provides functional support, suitable for structural defects. It is mostly used to treat non - union of bones. The use methods include onlay bone grafting, inlay bone grafting, intramedullary bone grafting, and bilateral onlay bone grafting.
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Cancellous bone grafting: Cancellous bone graft has a viable cell and pore structure, which makes it easy to reconstruct blood vessels. It provides an osteoinductive, osteoconductive, and osteogenic substrate, but is not suitable for structural defects that require immediate mechanical stability. It is mostly used to fill bone defects and perform various fusion operations.
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Infection at the surgical site: The surgical site may be infected by bacteria, resulting in symptoms such as fever, pain, and swelling.
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Graft absorption: The implanted bone tissue may be absorbed, leading to surgical failure.
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Donor - site complications: The bone - harvesting site may have complications such as pain, swelling, bleeding, and infection.
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Functional disorders: The surgical site may have functional disorders such as limited movement and abnormal sensation.