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Orthopedic Services
Glendale Adventist Medical Center
1509 Wilson Terrace
Glendale, CA 91206
Ph: (818) 409-8000

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My brother was in the wrong place at the wrong time and took a bullet to his lower leg. He ended up with a major bone fracture they think might result in a significant shortening of the bone. Isn't there some way they can make a fake bone or something to keep the leg length? I'm thinking this could be a terrible disability if they can't do something about it.

Severe bone fractures do present quite an orthopedic and surgical challenge. Preventing bone loss, limb shortening, and to be honest, even amputation is an important goal. But the best way to do this isn't always clear. There are various reconstruction methods currently being used for what amount to large segmental bone defects such as you are describing. Tissue engineering and tissue regeneration are the topics of many studies right now. Current management techniques for significant bone injuries do include bone grafting, bone transfer, and synthetic (manmade) calcium-based bone fillers. And another technique called induced membrane is under investigation. This two-stage surgical procedure has been introduced with good early success in bone reconstruction. In the first step, a temporary spacer is placed in the area of bone loss. The implanted device is called a polymethylmethacrylate (PMMA) spacer. PMMA is a type of cement that helps hold everything together. The spacer is "bioactive" meaning it will stimulate bone growth. An antibiotic is also mixed in with the cement to help prevent infection. In the second stage, the membrane is filled with allograft bone graft material taken from a bone graft (allograft means it is donor tissue from a bone bank). The cement spacer stays in place for one to two months -- long enough to allow the membrane to become active. Removal of the spacer may be delayed if there is significant soft tissue injury that needs more time to heal. Recovery time is still lengthy with full weight-bearing for leg injuries achieved six to 10 months later. Severe arm and/or hand injuries treated this way also require many months for healing and rehab to take place. Full healing of the fractured bone can take up to a full year. But surgeons and patients agree that the time delay is worth it if the limb can be saved from significant shortening or even amputation. One of these techniques may be under consideration for your brother. It never hurts for the patient to ask what his (or her) treatment options are and to explore new ideas being investigated in other parts of the country.


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