Autogenous non-vascularized bone graft in segmental mandibular reconstruction: a systematic review

This systematic review assesses the quality and outcomes of published articles concerning bone graft surgery for scaphoid fracture non-union. Searches of the CENTRAL, MEDLINE, EMBASE, CINAHL and AMED databases captured 2710 articles. Each article was screened and 144 met our inclusion criteria. Data regarding source, study design, population, intervention, comparator and outcomes were extracted. There were 5464 scaphoid non-union outcomes within the 144 studies. Mean reported union rates for vascularized and non-vascularized bone graft were 84% and 80%, respectively. Avascular necrosis was diagnosed in several ways and, when present, the vascularized bone graft union rate was 74% compared with 62% with non-vascularized bone graft. Reported union rates vary considerably. These differences may be due to patient factors, fracture factors, treatment factors or study design failures or bias. We recommend that future researchers take into account the deficiencies of previous studies and use the suggested minimum data set in future studies. Level of evidence: II

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The Advantages of Vascularized Fibular Bone Graft For Mandibular Tumor Reconstruction

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i1.31 ◽

1970 ◽

Vol 1 (1) ◽

Cited By ~ 1

Author(s):

Parintosa Atmodiwirjo ◽

Nandita Melati Putri

Keyword(s):

Oral Cavity ◽

Bone Graft ◽

Plastic Surgery ◽

Bone Healing ◽

Mandibular Reconstruction ◽

Surrounding Tissue ◽

Vascularized Bone Graft ◽

Mandibular Tumor ◽

Oral Cavity Tumor ◽

Vascularized Bone

Mandibular reconstruction are often indicated in patient who underwent ablation or excision of the mandible due to malignancy of the oral cavity.In this paper we will discuss about the mandibular reconstruction with use of alloplastic implant, and vascularized bone graft. Four cases of oral cavity tumor which were referred to the plastic surgery division at Cipto Mangunkusumo hospital during 2005-2011, after being diagnosed with oral cavity tumor were re-viewed. Mandibular reconstruction can be done using alloplastic implant, non-vascularized bone graft or vascularized bone graft. In this paper we studied four patients who needed mandibular reconstruction after ablation of oral cavity tumors. Patients who underwent reconstruction with alloplastic implants all had complications such as broken hardware. Where as in patient who underwent free fibular tissue transfer there were no complications at all. We can conclude that in less vascularized surrounding tissue as in cases that received or will receive other treatment such as chemotherapy or radiation that vascularized bone graft are superior. The bone healing in vascularized bone graft also does not depend on creeping substitution like in non vascularized bone graft.

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Systematic review of Surgical Management of Early Stages of Kienböck’s Disease

QJM ◽

10.1093/qjmed/hcaa059.002 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A A K H Abouelela ◽

A Nabil ◽

M A Lami

Keyword(s):

Systematic Review ◽

Bone Graft ◽

Range Of Motion ◽

Core Decompression ◽

Vascularized Bone Graft ◽

Kienböck’S Disease ◽

Kienböck's Disease ◽

Early Stages ◽

Vascularized Bone ◽

Kienbock’S Disease

Abstract Background Kienbock’s disease, or avascular necrosis of the lunate, is a rare debilitating condition that can lead to chronic pain and dysfunction in the wrist. It is classified into four stages according to lichtman staging. Different modalities of surgical treatment are proposed for early stages in which no carpal collapse is found. These modalities include radius core decompression, joint leveling procedures and vascularized bone graft. Objective To conduct a systematic review comparing the different surgical modalities in management of early stages of kienbock’s disease. Methodology The search was conducted by using the databases: MEDLINE, Cochrane library and JBJS {Journal of bone and joint Surgery} and PubMed. Data was independently extracted by two reviewers and crosschecked. Outcome measures included improvement of pain, range of motion, hand grip and postoperative complications. Results This systematic review included 11 paper of which 3 papers about core decompression, 7 about different joint leveling procedures and only one paper about vascularized bone graft. Core decompression papers included 41 patients most of them reported good improvement in the VAS score postoperatively. Joint leveling papers included 108 patients and reported mild improvement in range of motion and grip strength but complications like residual ulnar-sided wrist pain and carpal collapse were reported postoperatively. Vascularized bone graft paper included 13 patient of mean age 39 years and reported good improvement in grip strength, range of motion but mild improvement in VAS score. Conclusion Till now literature has no strong evidence to support that one of Core decompression, joint leveling procedures or lunate vascularized bone graft is superior in management of early stages of kienbock’s disease.

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