Spontaneous healing of large femoral cortical bone defects :
does genetic predisposition play a role ?
Published online: Oct 27 2003
Andreas F. HINSCHE, Peter V. GIANNOUDIS, Stuart E. MATTHEWS, Raymond M. SMITH
From the Department of Orthopaedic and Trauma Surgery, St James’s University Hospital Leeds, UK.
Abstract
Traumatic segmental femoral defects are commonly
high velocity injuries and their reconstruction necessitates
challenging surgical procedures. These
injuries present commonly as open fractures and
thorough wound debridement followed by adequate
soft tissue cover is mandatory before skeletal reconstruction
can be commenced. The definitive reconstructive
procedure is therefore often delayed and the
optimal treatment option is frequently determined
by the extent of the cortical defect. The complication
rate is high and femoral non-union is not uncommon
in these injuries but associated head injuries as part
of a polytrauma can have a positive effect on fracture
healing. We are presenting a series of four cases, in
which traumatic segmental femoral defects of 6, 9, 10
and 15 cm without associated head injury healed
spontaneously while the patients were waiting for a
definitive skeletal reconstructive procedure.