The use of bone chips is an excellent method of treating localized cystic osteitis fibrosa. It certainly is superior to simple scraping and the use of caustic substances. The cavity can be filled much easier with chips than with solid cortical bone grafts, and it seems also that the power of osteogenesis is greater with the use of chips. Giant-cell tumors are not so susceptible to this form of treatment, especially if they are in the more advanced stage and if too great a defect results after the curettage of the tumor tissue. Nevertheless, the author obtained a very good result in one case in which the entire lateral condyle was involved.
Care should be taken to fill the defect with the chips as completely as possible. If necessary, both tibiae may be used as donors. In too advanced cases or in recurrent cases of giant-cell tumor, resection with heavy, bridging, tibial grafts is preferable to the less radical procedures, such as curettage and the use of bone chips, and to the more radical ones, such as amputation and exarticulation.
(C) 1937 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.