Reimplantation of a Large Extruded Segment of Bone in an Open Fracture

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• 作者：Ahmadreza Afshar ; MD^&lowast ; ; ^{afshar_ah@yahoo.com}
• 关键词：Extruded bone ; open fracture ; reimplantation ; povidine-iodine ; chlorhexidine gluconate
• 刊名：The Journal of Hand Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：42
• 期：2
• 页码：128-134
• 全文大小：167 K
• 卷排序：42

文摘

Replacing an extruded segment of bone in an open fracture imposes a challenging decision concerning the best and safest patient management. There are numerous advantages to restoring the patient’s own extruded bone segment to its original location, particularly when the bone segment is of structural importance. However, reimplantation of contaminated and avascular extruded bone segments can potentially result in serious infection or nonunion. There is no conclusive evidence regarding the best decontamination protocol for the safest use of the recovered bone segment as an autologous graft. Among the different chemical sterilization solutions 10% povidone-iodine and chlorhexidine gluconate solutions are the author’s most preferred solutions. Regarding cellular toxicity, 10% povidone-iodine has been found to be the most favorable among the readily available solutions.