Reimplantation of a Contaminated and Devitalized Bone Fragment After Autoclaving in an Open Fracture

Successful Immediate Re-implantation of an Extruded Femoral Segment: A Case Report

“…They described boiling the fragment and then sterilizing it in an autoclave immediately before re-implantation [5]. Since then, several authors described their successful experiences with different sterilization techniques including boiling, autoclaving, gamma irradiation, and soaking in chlorhexidine, povidone-iodine, and antibiotic solutions [3][4][5][6][7][8][9][10][11][12][13]. Autoclaving seems to be the most efficient method of decontamination but there are multiple concerns regarding loss of graft osteoinductive properties [4,14].…”

Open Diaphyseal Long Bone Fractures: A Reduction Method Using Devitalized or Extruded Osseous Fragments

“…27,28,[36][37][38] Although autoclaving is a well-accepted routine sterilization technique and an alternative method for fragment decontamination prior to introduction to the sterile field, [39][40][41] this technique may render the fragments substantially softer and prone to crushing or fragmentation when manipulated with reduction clamps. Whereas the complete excisional debridement of nonviable bone forms the foundation of successful treatment, 11,23-26 use of these fragments prior to their elimination can greatly aid the surgeon in accurately restoring limb alignment, length, and rotation.…”

Replacement of an Extruded Segment of Radius after Autoclaving and Sterilising with Gentamicin

“…Autogenous, non-vascularised bone graft can be used successfully if the extruded bone segment is unavailable. Although simple bone grafting is not the procedure of choice today, it does offer the trauma surgeon another treatment option in dealing with this problem (Kao and Comstock, 1995).…”

“…It is possible to conceive various ways of sterilising bone and many methods will have been used sporadically in the past. Regardless of the option of sterilisation chosen, meticulous wound debridement and sound principles in respect of bone stabilisation and wound care are necessary for a successful outcome (Kao and Comstock, 1995).…”