Autogenous bone grafts have come to be generally employed in the treatment of ununited fractures, with the exception of those of the neck of the femur and carpal navicular, where other methods are not infrequently used. In case of an ununited fracture of the shaft the grafted material may be made to serve as internal fixation apparatus, supplementary bone, osteogenic substance and stimulant to osteogenesis in those parts of the bone fragments which come in contact with it. Analysis of cases reveals that there is considerable variation in the necessity for any one of these functions according to the case at hand. Thus if the fragments are little atrophied and no bone has been lost there will be less necessity for supplementary bone than if atrophy is marked and if portions of cortex have been lost. Also if the cause of the nonunion is wide separation of fragments there will
HARKINS HN, PHEMISTER DB. SIMPLIFIED TECHNIC OF ONLAY GRAFTS: FOR ALL UNUNITED FRACTURES IN ACCEPTABLE POSITION. JAMA. 1937;109(19):1501–1506. doi:10.1001/jama.1937.02780450005002
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