title: Spontaneous healing of large femoral cortical bone defects: does genetic predisposition play a role?
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.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, St James's University Hospital, Leeds, UK. a.hinsche@virgin.net
authors.forename: Andreas F
authors.initials: AF
authors.lastname: Hinsche
authors.forename: Peter V
authors.initials: PV
authors.lastname: Giannoudis
authors.forename: Stuart E
authors.initials: SE
authors.lastname: Matthews
authors.forename: Raymond M
authors.initials: RM
authors.lastname: Smith
mesh_terms: D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D001860:Bone Plates; D016723:Bone Remodeling / Q000235:genetics* / Q000502:physiology*; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma; D011379:Prognosis; D011859:Radiography; D012075:Remission, Spontaneous; D012494:Sampling Studies; D016896:Treatment Outcome