BONE-GRAFTING IN FOOT AND ANKLE SURGERY - A REVIEW OF 300 CASES

Three hundred foot and ankle bone grafts were reviewed in three separa te series of 100 consecutive grafts from two institutions. The series represent a period from 1977 to 1990 and demonstrate treatment pattern s that varied over time and between institutions in indications, graft material, and perioperative management. Over 42% of the 300 grafts we re for calcaneal osteotomies; most were Evans calcaneal osteotomies. O ver 72% of the grafts were allogeneic bone-bank bone, which performed well in calcaneal osteotomies and for packing of defects. Upon review of the incidence of bone complications, no significant differences wer e observed between surgical procedures that used autogenous versus all ogeneic grafts. However, four out of six failures of first metatarsal repair were with allogeneic bone. There was a significant difference i n complication rates for the major indications for bone-graft surgery. Nonunions and arthrodeses resulted in higher complication rates than expected, whereas calcaneal osteotomies resulted in a lower complicati on rate than expected.