Wrist Arthrodesis Using an Embedded Iliac Crest Bone Graft

1993 ◽  
Vol 18 (5) ◽  
pp. 595-600 ◽  
Author(s):  
E. LENOBLE ◽  
H. OVADIA ◽  
D. GOUTALLIER
Keyword(s):  
Bone Graft ◽  
Grip Strength ◽  
Iliac Crest ◽  
Delayed Union ◽  
Iliac Crest Bone Graft ◽  
Iliac Crest Graft ◽  
Wrist Arthrodesis ◽  
Carpometacarpal Joints ◽  
Dorsal Branch

34 patients treated by the iliac crest bone graft technique for wrist arthrodesis were reviewed. The average age was 45.6 years and the mean follow-up was 45 months. The procedure is performed through a straight ulnar approach and the head of the ulna is removed. A longitudinal trench is created in both distal radius and carpus preserving the anterior, posterior and lateral cortices. A curved trapezoidal monocortical iliac crest bone graft is embedded inside the trench. The position of the arthrodesis automatically follows the curvature of the graft. No fixation device is used. A short-arm cast is applied for 2 to 3 months. All arthrodeses except two fused within 3 months. Pain was completely relieved in 85% of the cases. Pronation and supination returned to normal 5 months post-operatively. Grip strength was increased in 80% of the cases. The carpometacarpal joints remained pain-free even when not fused. Complications were rare: two lesions of the dorsal branch of the ulnar nerve; two cases of delayed union due to errors in technique, and displacement of the graft in one case. Although it is technically demanding, the embedded iliac crest graft wrist arthrodesis improves pronation and supination as a result of resection of the distal radio-ulnar joint, preserves or improves grip strength, and relieves pain.

scholarly journals Structural Bicortical Autologous Iliac Crest Bone Graft Combined with the Tunnel Bone Tamping Method for the Depressed Tibial Plateau Fractures

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Zhongzheng Wang ◽  
Yanbin Zhu ◽  
Xiangtian Deng ◽  
Xin Xing ◽  
Siyu Tian ◽  
...  
Keyword(s):  
Bone Graft ◽  
Tibial Plateau ◽  
Iliac Crest ◽  
Short Form ◽  
Tibial Plateau Fractures ◽  
Absolute Difference ◽  
Iliac Crest Bone Graft ◽  
Special Surgery ◽  
The Mean

Background. Clinically, autologous iliac crest bone grafts (ICBG) and bone tamping methods are often applied to manage depressed tibial plateau fractures (DTPFs). The purpose of this study was to describe and evaluate the technique of using structural bicortical autologous ICBG combined with the tunnel bone tamping method (TBTM) for treating DTPFs. Methods. All patients with DTPFs who underwent structural bicortical autologous ICBG combined with TBTM from January 2016 to February 2018 were prospectively analysed. Demographics, injury, surgery, postoperative complications, and clinical outcomes were recorded. All patients were followed up for more than 30 months. Postoperative radiography and CT were employed to assess fracture healing and the reduction quality. Results. Forty-three of the included patients completed the follow-up. No malreduction was observed. Based on the immediate postoperative imaging, the intra-articular step-off was significantly reduced (8.19 mm preoperatively vs. 1.30 mm immediate postoperatively, P < 0.001 ). From the immediate operation to the latest follow-up, the reduction was maintained significantly well, with a nonnegligible absolute difference (0.18 mm, P = 0.108 ). A remarkable secondary loss of reduction (intra-articular step   off > 3   mm ) was found in two elderly patients (2/43, 4.65%). The incidence of complications related to the bone-graft donor and bone-graft site was 2.33% and 4.65%, respectively. At the final follow-up, the mean Hospital for Special Surgery (HSS) score of the knee was 98.19 ± 2.89 , and the mean 36-Item Short-Form Health Survey (SF-36) score was 95.65 ± 4.59 . Conclusion. Structural bicortical autologous ICBG combined with TBTM is radiologically effective and stable in terms of complications for the DTPFs.

Primary Fusion as Salvage following Talar Neck Fracture: A Case Report

2003 ◽  
Vol 24 (4) ◽  
pp. 368-371 ◽  
Author(s):  
Rhys H. Thomas ◽  
Timothy R. Daniels
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Bone Graft ◽  
Range Of Motion ◽  
Avascular Necrosis ◽  
Iliac Crest ◽  
Iliac Crest Bone Graft ◽  
Type Iv ◽  
Neck Fracture

For a 29-year-old man with a three-week-old Hawkins Type IV talar neck fracture, intra-operative reduction and fixation were not possible due to soft tissue contractures and severe comminution. A primary talonavicular and subtalar arthrodesis with the use of iliac crest bone graft was performed. Postoperative follow-up at 16 months demonstrated solid fusions, no avascular necrosis of the talus and a functional range of motion at the ankle. He was not capable of returning to his job of roof maintenance.

scholarly journals Outcomes and complications of the reamer irrigator aspirator versus traditional iliac crest bone graft harvesting: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Francesco Oliva ◽  
Filippo Migliorini ◽  
Francesco Cuozzo ◽  
Ernesto Torsiello ◽  
Frank Hildebrand ◽  
...  
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Meta Analysis ◽  
Medullary Canal ◽  
Current Evidence ◽  
Iliac Crest Bone Graft ◽  
Bone Graft Harvesting ◽  
Mean Time ◽  
Lower Site

Abstract Background The reamer irrigator aspirator (RIA) is a relatively recent device that is placed in the medullary canal of long bones to harvest a large volume of bone marrow, which is collected in a filtered canister. This study compares outcomes and complications of the RIA versus a traditional iliac crest bone graft (ICBG) for the treatment of bone defects. Methods This meta-analysis was conducted according to the PRISMA guidelines. The Embase, Google Scholar, PubMed, and Scopus databases were accessed in June 2021. All clinical trials comparing the RIA and ICBG with a minimum of 6 months follow-up were included. Results Data from 4819 patients were collected. The RIA group demonstrated lower site pain (P < 0.0001), fewer infections (P = 0.001), and a lower rate of adverse events (P < 0.0001). The ICBG group demonstrated a greater rate of bone union (P < 0.0001). There was no difference between groups in VAS (P = 0.09) and mean time to union (P = 0.06). Conclusion The current evidence supports the use of the RIA, given its low morbidity and short learning curve.

Non-Vascularized Tri-Cortical Iliac Crest Graft–A Reliable Option in the Management of Scaphoid Waist Non-Unions

2021 ◽  
Vol 26 (03) ◽  
pp. 383-389
Author(s):  
Vivek Singh ◽  
Nagaraj Manju Moger ◽  
Pragadeeshwaran Jaisankar ◽  
Surjala Rajkumar ◽  
Sunny Chaudhary ◽  
...  
Keyword(s):  
Iliac Crest ◽  
Wrist Joint ◽  
Successful Outcome ◽  
Iliac Crest Bone Graft ◽  
Bony Union ◽  
X Rays ◽  
Iliac Crest Graft ◽  
Non Union ◽  
Functional Scores

Background: Scaphoid non-union often leads to a change in biomechanics of the wrist joint. Various types of bone grafts and different sites of harvest have been described in the literature for scaphoid reconstruction. This study was conducted to assess the clinical and radiological outcome after non-vascularised tri-cortical iliac crest bone graft for non-union of scaphoid waist fractures. Methods: 12 adult patients who underwent reconstruction of scaphoid waist non-union with tricortical iliac crest grafting and internal fixation with headless compression screws (11 cases) and k-wires (1 case) were prospectively analysed. There were 11 males and 1 female (mean age 23.9 years). The mean duration of presentation was 5.7 months following injury. Outcome following surgery were analyzed clinically by range of movements (ROM) and functional scores like DASH and modified Mayo wrist score and radiologically by X-rays and Non contrast CT of the wrist. Radiological assessment included scaphoid length, radio-lunate (RL) angle and scapho-lunate (SL) angle at latest 6 months follow up. Results: Bony union was achieved in 10 cases (union rate 83%). All the cases which achieved union had a significant improvement in radiological and clinical outcome criterias at 6-month follow-up interval. 1 patient had persistent non-union and 1 had k-wire back out with fixation failure. Conclusions: It is important to restore scaphoid length and to correct flexion deformity for a successful outcome. This can reliably be acheived by a carefully planned wedge-shaped iliac crest graft along with secure fixation with a headless compression screw.

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