Reliability of Bone Scintigraphy to Assess the Survival of Free Bone Transfers: Limitations of the Method

Advances of microsurgery over the past 15 years have made it possible, in selected indications, to provide continuing blood flow circulation to bone autografts. These techniques have been developed in an attempt to avoid the problems of revascularization of conventional bone autografts (necrosis of large cortical autografts, with secondary weakening when creeping substitution occurs). The vascularized bone grafts have the advantages of the non-vascularized ones, as well as the advantages of preserved viability [1–3, 7–10]. Strong living cortical bone is transplanted; the graft does not become weaker as no creeping substitution occurs. Both the graft and the recipient bone contribute to callus formation: the problem is essentially reduced to one of double fracture healing, rather than of graft incorporation. Graft hypertrophy in response to mechanical stimulations is observed. Vascularized bone grafts, being independent of the surrounding vascularity of the recipient bed, appear also to tolerate irradiation or resist infection.