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General Orthopaedics

EARLY EFFICACY OF DEEP-FROZEN BONE ALLOGRAFTS IN TREATMENT OF FRACTURES REQUIRING BONE GRAFTS

The British Indian Orthopaedic Society (BIOS) 21st Conference, Leicester, England, June 2019.



Abstract

Osteogenic augmentation is required in various orthopaedic conditions. Autograft is the gold standard but has limitations of increased morbidity and limited amount. Bone graft substitutes are costly and limited and don't integrate with host bone. Deep freezed allografts are a viable option, though not widely used in India and there are sparse reports in literature. This paper studies early efficacy of deep freezed bone allografts in treatment of fractures requiring bone graft.

This is a prospective descriptive study. Strict inclusion and exclusion criteria as per standard guidelines were followed. We have a in-house facility of gamma irradiated deep freezed allografts available in hospital. 20 patients with comminuted fracture, delayed / malunion / nonunion, depressed intra articular fractures were operated during one year and followed up for at least 24 weeks. Sloof's Criteria was used for assessing osteointegration of grafts. Efficacy was authenticated by observing complications like serous discharge from surgical site, infection (superficial/deep), rejection of graft, clinical and radiological integration of graft, maintenance of articular reduction etc. Allografts have not only accepted well but fractures have healed and bone integration is at various stages. Only one patients got infected (5%). The overall success rate in terms of adequate osteointegration is 95 %. 19 out of 20 patients in our study group had either attained or at various stages of osteointegration and healing.

We concluded that deep freezed bone allografts is a viable option in patients with fractures requiring bone grafts, thus give satisfactory surgical outcome, with no serious side effects.


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