Immediate autografting of bone in open fractures with bone loss of the hand: A preliminary report - Case reports

Three patients with open fractures of the hand associated with bone loss we re treated within four to six hours of injury by corticocancellous bone gra fting and soft tissue coverage after meticulous debridement, copious irriga tion of the wounds, and broad-spectrum antibiotics given intravenously. Lon g term follow-up was uneventful and showed that the graft had taken and hea led well with early and full restoration of function and a good cosmetic re sult. Immediate corticocancellous bone grafting of an injured hand could be used in selected cases with well-debrided, surgically clean wounds as long as there is a rich blood supply. Adequate bone fixation, soft tissue cover age, and broad-spectrum antibiotics given intravenously will remove the ris k of infection. Hand architecture is corrected while wound contracture and secondary deformity-are avoided. Both patients' discomfort and hospital cos ts are considerably reduced.