Graftfraktur

Graftfraktur is a medical term describing a fracture that occurs within a graft material implanted to repair or augment bone, rather than a fracture of the patient's native bone at the graft site. It is most commonly discussed in orthopedic and maxillofacial contexts where bone grafts support reconstruction, bridge defects, or enhance stability after injury or surgery.

Bone grafts involved in graftfraktur can be autografts (tissue taken from the patient), allografts (donor tissue), or synthetic substitutes such as ceramics or bioactive scaffolds. Graft fractures have been described in settings including long-bone reconstruction, spinal fusion, and maxillofacial procedures, as well as in dental implant rehabilitation where grafts provide foundational support.

Causes include excessive mechanical loading before graft incorporation, inadequate graft size or fit, resorption, infection, or impairment of the graft’s blood supply. Risk factors encompass smoking, diabetes, malnutrition, corticosteroid therapy, radiation, and poor fixation stability.

Diagnosis relies on radiographic imaging; CT or MRI can clarify graft integrity and the condition of surrounding host bone. Management depends on the site and extent of the fracture and may involve protected weight-bearing or immobilization, revision surgery to replace or augment the graft, and adjustments to fixation hardware. In some cases, a vascularized bone graft or alternative reconstruction is required to restore viability.

Prognosis varies with graft type and vascularity; successful healing depends on graft incorporation and mechanical stability. Prevention focuses on appropriate graft selection and sizing, secure fixation, staged rehabilitation, and measures to optimize vascularity and soft-tissue coverage, along with addressing risk factors such as smoking and nutrition.