The Survival of Free Nonvascularized Bone Grafts in Irradiated Areas by Wrapping in Muscle Flaps

In this paper, the concept of vascularizing the bed as opposed to the bone was tested with regard to bone grafting in irradiated areas. Thirteen rabbits underwent cross-transfer of a healthy rib into a bed that received 4500 rads of orthovoltage radiation. Eight of these grafts were wrapped in rotated, nonirradiated latissimus dorsi muscle. At 3 months, these grafts were evaluated radiologically, grossly, and histologically. Seven of eight grafts wrapped in muscle demonstrated evidence of union and survival (88 percent), whereas only one of five of those grafts placed directly into the irradiated bed demonstrated union and survival (20 percent). Statistical analysis showed this to be significant to 97.5 percent, with a lambda 2 value of 5.9.