Papineau grafting, or open cancellous bone grafting, was initially described 40 years ago for the management of cavitary defects resulting from radical debridement of infected bone and soft tissue. Although minor modifications have been made to the original protocol as described by Papineau, the main stages of the procedure have been largely preserved. The 3 stages of the protocol include debridement of necrotic or infected tissue, open cancellous bone grafting, and soft tissue coverage. This paper will provide a review of the recent literature and describe the technique of open cancellous bone grafting. Illustrative cases of its application in foot and ankle surgery are also provided.
Dr. Eva Umoh Asomugha is Resident Physician, Department of Orthopedic Surgery, Cleveland Clinic Foundation, Cleveland, OH, 44122. Dr. Ian James Alexander is Clinical Professor, Department of Orthopedic Surgery, Medina Hospital, Medina, OH, 44256. From the Cleveland Clinic Health System, Cleveland, OH
All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.
The authors have disclosed that the U.S. Food and Drug Administration has not approved the use of rhBMP-2 for the treatment of bone grafts as discussed in this article. Please consult the product’s labeling for approved information.
Address correspondence and reprint requests to Eva U. Asomugha, MD, Cleveland Clinic Health System, 9500 Euclid Avenue, Cleveland, OH 44124. E-mail: email@example.com.
INSTRUCTIONS FOR OBTAINING AMA PRA CATEGORY 1 CREDIT™
Techniques in Foot & Ankle Surgery includes CME-certified content that is designed to meet the educational needs of its readers. This activity is available for credit through June 30, 2015.
To earn CME credit, you must read the CME article and complete the quiz, answering at least 80 percent of the questions correctly. Mail the completed quiz, along with a check or money order for the $10.00 processing fee, to the Lippincott CME Institute, Inc., Wolters Kluwer Health, Two Commerce Square, 2001 Market Street, 3rd Floor, Philadelphia, PA 19103; fax: 215-827-5614. Only the first entry will be considered for credit, and must be postmarked by the expiration date. Answer sheets will be graded and certificates will be mailed to each participant within 6 to 8 weeks of participation.
Lippincott Continuing Medical Education Institute, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Credit Designation Statement
Lippincott Continuing Medical Education Institute, Inc., designates this journal-based CME activity for a maximum of 1 (one) AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.