Procedures

Tibial Non-Union
Using Grafton® DBM Putty and
Morselized Allograft

Ronald W. Lindsey, M.D.
Professor of Orthopedic Surgery
Baylor College of Medicine, Houston, Texas
The patient is a 36-year-old male who sustained a Grade 2 comminuted open tibial fracture approximately nine months before the grafting procedure. The fracture occurred at the junction between the metaphysis and diaphysis. There was some healing on the metaphyseal side, but required a graft at the metaphyseal/diaphyseal junction.

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The host bed is meticulously prepared to bleeding bone.
 The Grafton® DBM Putty and allograft bone chips are mixed together and placed initially.
The bone defect is then packed tightly with the allograft-Grafton® mixture.
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"In our institution, cancellous allograft bone in combination with the Grafton® DBM putty is now the standard method for tfreating all fractures requiring bone grafts, acute or non-union."

Dr Ronald Lindsey
General Remarks
Dr. Lindsey used allograft bone that was processed by Osteotech, Inc. Following are Dr. Lindsey's guidelines for use.
Indications for Use of the Bone Allograft-Grafton®
All cases indicated for bone grafting are suitable for use wfth the allograft-Grafton® mixture.

Detailed Description
  • Follow all guidelines listed on product inserts.

  • The allograft bone tissue is removed from original package using standard aseptic conditions and placed in the plastic tray.

  • The allograft cancellous bone croutons are soaked in the sterile saline solution and left completely immersed for 20-30 minutes prior to usage.

  • The amount and size of allograft necessary for the orthopedic procedure are based upon the size and type of the bone defect.

  • The container with Grafton® DBM Putty is then opened under sterile conditions.

  • The cancellous bone croutons are morselized into small chips.
  • The Grafton® DBM Putty is added to the plastic tray containing allograft bone chips within the ratio 3 - 4 volume units of allograft and 1 unit of Grafton® DBM Putty.

  • The Grafton® DBM Putty and allograft bone chips are mixed together for a couple of minutes until the homogenous mixture is reached.
  • In the meantime, the bed for the allograft is prepared by meticulously cleansing; i.e., debridement of any nonviable tissues in a case of infection or open trauma, removal of fibrous tissue in a case of non-union; followed by pulsatile irrigation.

  • The bone defect is then packed tightly with the allograft-Grafton® mixture.

  • Following proper bone grafting techniques, no irrigation can be performed after the graft has been placed.

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