Bone grafting
Bone grafting is a surgical procedure used to repair or reconstruct bone defects caused by various factors such as congenital malformations, trauma, cancer, or bone diseases. The process often involves transferring bone tissue from one part of the patient's body to another, known as an autogenous graft, which minimizes the risk of rejection. In cases where there isn't enough available autogenous bone, surgeons may use allogeneic grafts from cadaver sources, albeit with a higher risk of rejection. Bone grafts support healing in situations like delayed unions of fractures, spinal fusions, and after surgeries such as hip or knee replacements. The material used for grafting typically includes cancellous bone, which is the spongy tissue found in major bones, often harvested from the pelvis. Successful bone grafting relies on the graft's ability to integrate, vascularize, and ultimately be replaced by new bone tissue. Overall, bone grafting plays a crucial role in orthopedic and reconstructive surgery, providing essential support for patients recovering from significant bone injuries or surgeries.
Bone grafting
Anatomy or system affected: Bones, immune system, musculoskeletal system
Definition: The transplantation of a section of bone from one part of the body to another or from one individual to another.
Indications and Procedures
Ideally, the grafting procedure involves the transfer of bone tissue from one site to another on the same individual, which is termed an autogenous graft. This method eliminates the chance of rejection, allowing the transplantation of entire functional units of tissue: arteries, veins, and even nerves, as when a toe is used to replace a finger or thumb (toe-digital transfer). Autogenous rib or fibula grafts may be utilized for the reconstruction of the face or extremities. Doctors sometimes use cadavers as the source of bone tissue
Bone grafts are used in many situations, including complications from bone diseases and cancer, spinal fusion surgery, dental implant surgery, and major surgical implants such as a total knee or hip replacement survey. Bone grafts are often used in situations in which a bone fracture is not healing properly. A fracture that fails to heal in the usual time is considered to be a delayed union. Cancellous material from the bone (the spongy inner material), usually obtained from the iliac crest of the pelvis or from the ends of the long bones, is placed around the site. The fracture must then be immobilized for several months, allowing the grafted material to infiltrate and repair the fracture.
Uses and Complications
The grafting of bone tissue is carried out to correct a bone defect, to provide support tissue in the case of a severe fracture, or to encourage the growth of new bone. The source of the skeletal defect may be congenital malformation, disease, or trauma. For example, reconstruction may be necessary following cancer surgery, particularly for the jaw or bones elsewhere in the face.
If the autogenous bone supply is inadequate to fill the need, allogeneic bone grafts, the transplantation of bone from an individual other than an identical twin, may be necessary. Such foreign tissue is more likely to undergo rejection, reducing the chance of a successful procedure; the more closely the tissues of the two persons are matched, the less likely rejection will be a problem.
If the graft is able to vascularize quickly and synthesize new tissue, the procedure is likely to be successful. The graft itself may provide structural support, or it may gradually be replaced by new bone at that site, completing the healing process.
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