Distal 3rd Diaphysial Fracture of Humerus Fixed with Dynamic Compression Plate Using Posterior Approach- The Assessment of the Outcome

Objectives: The effectiveness of open reduction and Dynamic Compression Plate (DCP) fixation with or without autogenous bone grafting using the posterior midline approach in the treatment of distal third diaphyseal humeral fractures was assessed. Methods: For humeral nonunion, comminuted fractures, or early failure of conservative therapies, 33 patients (24 men, 9 women; mean age 37 years; range 20 to 60 years) were operated on. The study was carried out at Dhaka Medical College Hospital (DMCH), Dhaka from July 2005 to December 2006. Results: After an average of 17 weeks, all of the patients had union (range 14 to 26 weeks).There was no deep infection, nonunion, malunion, implant failure, or nerve injury in any of the patients. In two cases, transient radial nerve palsy occurred. Minor infections were seen in four of the individuals. All of the patients were pain-free after surgery.The functional outcome was outstanding in all instances and good in 16 patients, yielding 87 % satisfying results. Functional outcomes increased considerably postoperatively compared to preoperatively (p<0.001). In 20 individuals, the range of motion of the shoulders was great. The range of motion at the elbow was considerable in 21 patients and moderate in seven others. More than three-quarters of the patients (75.8%) experienced no problems. Four patients (12.1%) were infected, and two patients (6.1%) developed iatrogenic radial nerve palsy as a result of the surgery. One patient (3%) had a loose screw, while another (3%) needed blood transfusions owing to extensive bleeding at the donor graft site. Conclusion: In distal third humeral fractures, open reduction and posterior DCP fixing, with or without autogenous bone grafting, is a safe and effective treatment option, especially when there is no infection or bony or neurovascular damage. Very few study conducted on distal 3rd diaphysial fracture of humerus fixed with DCP using posterior approach, therefore this study conducted to know the assessment of the outcome.

Immediate Implants with Early Loading Accompanying Autogenous Bone Grafting in a Maxilla with Periodontal Destruction: A Case Report

In the case of multiple hopeless teeth and severe bone loss, a conventional healing protocol of 3–4 months has been recommended to prevent the possibility of infection or unpredictable resorption of grafted bone during consolidation of the extraction socket. The use of a provisional denture is inevitable in the case of delayed implant placement, which is a common risk factor for wound dehiscence after a bone graft. Although autogenous bone is still the gold standard for bone grafting because of its excellent biocompatibility and osteogenic potential, there has been controversy in the unpredictable resorption of autogenous bone grafting. We present a case of successful maxillary rehabilitation without the use of provisional dentures by immediate implant placement, with early loading accompanying an extensive autogenous bone graft.

Bone Loss in Open Fractures

This chapter deals with the management of bone loss in open fractures with particular reference to the tibia. This is a challenging problem and requires input and expertise from orthopaedic and plastic surgery specialists in limb reconstruction. The different sizes, shapes, and location of the defect will have diverse implications, and management must be individualised. Individualisation of treatment entails an assessment of the local, systemic, and patient-related factors such that the optimum mode of treatment is chosen. The techniques available include autogenous bone grafting, with or without prior induced membrane creation, vascularised free transfer of bone, and bone regeneration by the Ilizarov method.

Reconstruction of maxillary anterior defect using autogenous bone graft-A case report.

Maxilla-mandibular discontinuity produces severe cosmetic and functional deformities. There are many options available for the reconstruction of the maxilla-mandibular osseous defects. Alloplastic materials like organic calcium salts or synthetic materials such as methylmethacylate, proplast and Teflon and larger reconstruction plates, have all been used for reconstruction with varying degrees of success. At present, autogenous bone grafting is the gold standard and mainstay for maxilla-mandibular bony reconstruction. Key Words- Autogenous bone graft, Maxillary defect, Classification

Application of 3D Printed Biocompatible Plastic Surgical Template for the Reconstruction of a Nasoalveolar Cleft with Preoperative Volume Analysis

Secondary autogenous bone grafting is the gold standard for the closure of an alveolar cleft. A preoperative surgical planning helps to determine the optimal shape and volume of the graft, that ideally guide canine eruption to the cleft area and ensure adequate nasal support. The authors describe their experience with design and use of an individually shaped 3D template for an autologous bone graft with fibrin glue for correct volume design. The conforming template is designed using freeware and open source software, it is manufactured by means of additive technology using autoclavable resin.