Advocates of vascularized bone grafts believe that these grafts should
have a decreased time to graft-host union, and that they should be
mechanically stronger than conventional (non-vascularized) grafts. The
objectives of the present study were to determine the rate and pattern of
repair in vascularized autogenous cortical bone grafts, to determine the
mechanical strength of the grafts, and to correlate the mechanical strength
with the biological repair. Forty-nine adult male mongrel dogs were divided
into six groups to evaluate conventional (non-vascularized), cuff
(periosteal-encased, non-vascularized), and vascularized segmental grafts.
The fibula was the site of experimentation and all grafts were
four-centimeter cortical segments. The vascularized and conventional grafts
were analyzed at two, six, twelve, and twenty-four weeks. The cuff grafts
were analyzed at twenty-four weeks and were compared with conventional
grafts to assess the effect of the periosteal soft tissue. Roentgenograms
were made every two weeks to evaluate the time to union. The mechanical
strength of each graft was assessed by determining rapid torsional load to
failure. Biological repair was assessed by tetracycline labeling for
new-bone formation and by microradiographic techniques for porosity and
cross-sectional areas. The study showed that conventional and cuff grafts
were similar in terms of mechanical and biological repair at six months. At
all sampling intervals, the vascularized grafts exhibited histological
findings that were consistent with viability. The conventional and
vascularized grafts underwent different mechanisms of repair. The
conventional, non-vascularized grafts healed by peripheral and internal
resorption followed by callus encasement and osteonal remodeling.(ABSTRACT
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