'Osteoplastic cuneiform osteotomy' in ankylosis of the knee joint or hip joint with a position of flexion or adduction has from an operative point of view-besides the maintaining of the truelength of the extremity-the technical advantage that the osteoplastic osteotomy, because of the osteotomies being laid in simple planes, can be carried out exactly as estimated beforehand. In consideration of this, the method would seem likely to be of use in other cases of similar nature and perhaps also be useful in plastic treatment of other bone deformities.
Osseous segments can be resected, boiled, and again implanted with a good prospect of union and function.
The union of boiled autoplastic bone segments in bone defects would seem to proceed clinically and roentgenologically in the same manner as the union of fresh autoplastic bone segments. The boiled segments seem, like fresh ones, to be mainly replaced by new bone tissue, while the old bone tissue undergoes necrosis and becomes resorbed. Smaller portions of necrotic bone tissue in the segments are for a long time evident in the roentgenogram. The boiled bone segments seem to be able to fulfil the mechanical function aimed at by the plastic operation.
After resection and reimplantation of segments in the diaphysis, periosteal bone regeneration is the dominating one; after such operations in the epiphysis, endosteal regeneration predominates.
A preliminary preparation of the bone graft for the purpose of removing, as completely as possible, connective tissue and fat from the bony canals would probably, in a grafting operation, hasten and render more complete the union and reconstruction of the graft. The author has worked out such a preliminary therapeutic method and is at present subjecting it to surgical tests.
Osteoplastic (autoplastic, homoplastic, heteroplastic) cuneiform osteotomy, carried out according to standard methods, is a relatively simple, practical, and efficacious method for clinically testing and evaluating bone transplantation generally as an aid to surgical therapy.
(C) 1932 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.