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  • Cambridge experience in spontaneous bone regeneration after traumatic segmental bone defect: a case series and review of literature

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Unusual presentation of more common disease/injury
Case report
Cambridge experience in spontaneous bone regeneration after traumatic segmental bone defect: a case series and review of literature
  1. Ali Abdulkarim1,
  2. Shu Yang Hu2,
  3. Brendon R Walker2 and
  4. Matija Krkovic1
  1. 1Department Of Trauma and Orthopaedic Surgery, Cambridge University Hospital / Addenbrooke's Hospital, Cambridge, UK
  2. 2Graduate Entry Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
  1. Correspondence to Mr Ali Abdulkarim; ali.abdulkarim{at}addenbrookes.nhs.uk

Abstract

High-energy traumatic long bone defects are some of the most challenging to reconstruct. Although cases of spontaneous bone regeneration in these defects have been reported, we are aware of no management guidelines or recommendations for when spontaneous bone regeneration should be considered a viable management option. We aim to identify how certain patient characteristics and surgical factors may help predict spontaneous bone regeneration. A total of 26 cases with traumatic segmental defects were treated at our institution, with eight cases (30.8%) undergoing spontaneous regeneration. We discuss four in detail. Six (75%) reported a degree of periosteal preservation, four (50%) were associated with traumatic brain injury and none were complicated by infection. The average time to spontaneous bone regeneration was 2.06 months. According to our cases, patients with favourable characteristics may benefit from delaying surgical treatment by 6 weeks to monitor for any signs of spontaneous bone formation.

  • orthopaedics
  • orthopaedic and trauma surgery

http://dx.doi.org/10.1136/bcr-2019-232482

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    Footnotes

    • Contributors AA and MK: conception and design, acquisition of data; drafting the article or revising it critically for important intellectual content; final approval of the version published. BRW and SYH: analysis and interpretation of data, conducting further research into the topic, drafting of original report. AA and SYH: agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.