Ilizarov Frame Fixation Without Bone Graft for Atrophic Humeral Shaft Nonunion: 28 Patients With a Minimum 2-Year Follow-Up

Abstract Background This study aimed to compare the radiological results between closed nailing without bone graft (BG) and open nailing with BG for aseptic subtrochanteric nonunion and to determine when an open procedure with BG should be considered. Methods In this retrospective study, we investigated patients who underwent surgical intervention for subtrochanteric nonunion between January 2008 and March 2018 in two institutions. Patients with infection, large bone defect, pathologic fracture, open fracture, previous surgery using plate, and follow-up of less than 1 year were excluded. We compared the demographic details and radiological results between patients who underwent the open procedure with BG (BG group) and the closed procedure without BG (non-BG group) as a historical control, and risk factors for the failure of revision surgery were evaluated. Results Thirty-seven patients met the criteria and were divided into the following two groups: the BG group (n=19) who underwent open nailing with BG and the non-BG group (n=18) who underwent closed reamed nailing without BG. The mean degrees of correction of varus and flexion deformity were significantly different (p=0.001, respectively), 6.2° and 2.9° in the BG group and 4.1° and 0.6° in the non-BG group, respectively. Bony union was observed in 17 cases (89.5%) in an average of 7.4 months in the BG group and in 16 cases (88.9%) in 7.6 months in the non-BG group, with no significant differences. The factors that were significantly associated with failure of revision were atypical fracture, two or more previous surgeries, and varus and sagittal anterior angulation. Conclusions The radiological results of closed reamed nailing without BG for subtrochanteric nonunion were satisfactory. In the effort of percutaneous realignment, gap reduction, and intramedullary reaming, the radiological results of closed nailing without BG were not different from those of open nailing with BG; therefore, closed procedure without BG may be an acceptable option in appropriately selected patients.

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Simultaneous Sinus Membrane Elevation and Dental Implant Placement Without Bone Graft: A 6-Month Follow-Up Study

Journal of Periodontology ◽

10.1902/jop.2010.100343 ◽

2011 ◽

Vol 82 (3) ◽

pp. 403-412 ◽

Cited By ~ 30

Author(s):

Fabio L. Borges ◽

Rafael O. Dias ◽

Adriano Piattelli ◽

Tatiana Onuma ◽

Luciana Ap. Gouveia Cardoso ◽

...

Keyword(s):

Bone Graft ◽

Dental Implant ◽

Follow Up Study ◽

Implant Placement ◽

Without Bone Graft ◽

Sinus Membrane Elevation ◽

Sinus Membrane

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Vascularised bone graft is an effective technique for extracortical bone bridging to combat cemented megaprosthesis loosening at the bone–implant junction

Journal of Orthopaedic Surgery ◽

10.1177/2309499020958167 ◽

2020 ◽

Vol 28 (3) ◽

pp. 230949902095816 ◽

Cited By ~ 1

Author(s):

Michelle Hilda Luk ◽

Andy Hon-Fai Yee ◽

Raymond Yau ◽

Kenneth Wai-Yip Ho ◽

Ying-Lee Lam

Keyword(s):

Bone Graft ◽

Aseptic Loosening ◽

Bone Growth ◽

Implant Loosening ◽

Implant Fixation ◽

Bone Implant ◽

Radiological Score ◽

Vascularised Bone Graft ◽

Without Bone Graft

Introduction: The bone–implant junction is a potential site for aseptic loosening. Extracortical bone bridging at the bone–implant junction is advocated to improve implant fixation by forming a biological seal. We propose a novel technique with vascularised bone graft (VBG) to form an extracortical bone bridge at the bone–implant junction to enhance implant stability. We compared the clinical and radiological outcomes for tumour megaprostheses performed (1) with and without bone graft and (2) with non-vascularised versus VBG technique. Methods: Forty-six tumour megaprosthesis procedures from 1 June 2007 to 31 October 2017 were identified from hospital records. Twenty-eight operations incorporated bone graft at the bone–implant junction, and 18 did not. Of these 28 bone graft procedures, 13 involved VBG, and 15 did not (non-VBG). The VBG technique involves resecting a short segment of healthy bone beyond the oncological margin with its preserved blood supply, splitting it, then securing it over the junction. Clinical outcomes assessed included loosening, fracture and recurrence. Extracortical bone growth at the bone–implant junction was quantified radiologically at intervals 0–24 months post-operatively. The mean follow-up was 4.27 years. Results: There were five incidences (27.8%) of loosening in the non-bone graft group compared to zero in the bone graft group ( p = 0.03). There was a higher radiological score of extracortical bone growth in the bone graft group compared to no bone graft at 3–24 months post-operatively ( p < 0.05). Within the bone graft group, the VBG group fared superior at 6 and 12 months post-operatively compared to non-VBG ( p < 0.05), as well as a lower rate of radiological junctional resorption ( p = 0.04). Conclusions: We recommend bone grafting for its merits of less implant loosening. We propose the VBG technique to combat early aseptic loosening in megaprosthesis replacement as there was a higher radiological score compared to non-VBG.

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Modified Lapidus Procedure for Hallux Valgus

Foot & Ankle ◽

10.1177/107110078900900602 ◽

1989 ◽

Vol 9 (6) ◽

pp. 262-266 ◽

Cited By ~ 203

Author(s):

Bruce J. Sangeorzan ◽

Sigvard T. Hansen

Keyword(s):

Bone Graft ◽

Hallux Valgus ◽

Medical Center ◽

Hallux Valgus Angle ◽

Intermetatarsal Angle ◽

First Metatarsal ◽

Valgus Angle ◽

First Ray ◽

Without Bone Graft

A modified Lapidus procedure was introduced at Harborview Medical Center in 1979 for the treatment of symptomatic hallux valgus with hypermobile first ray. The results of the procedures were reviewed retrospectively in 32 patients with 40 feet that were operated on between 1979 and 1984. Preoperative diagnosis was symptomatic hallux valgus complex with hypermobile first ray in 33 and failed bunion surgery in 7. Follow-up ranged from 30 months to 6 1/2 years. Union of the arthrodesis site occurred in 36 (90%). The average preoperative intrametatarsal angle was 14° (range 7.5 to 20°) and the hallux valgus angle was 26° (range 0 to 50°). At healing, the angles were as follows: intermetatarsal angle 6° (range 0 to 18°) and hallux valgus angle 11° (range −3 to 30°). The average change in the length of the first metatarsal was −5 mm for those without bone graft and +4 mm for those with bone graft. Of 33 feet operated on as a primary procedure, successful results were reported in 75% by our rating system. Of 7 feet operated on for failed previous surgery, all were improved. Best results were obtained in those with multiple screw fixation, use of bone graft, and attention to plantarflexion of the first metatarsal.

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Rupture of an Intramedullary Elastic Bundle Nail Following Humeral Shaft Nonunion: A Case Report

Journal of Long-Term Effects of Medical Implants ◽

10.1615/jlongtermeffmedimplants.2019030530 ◽

2019 ◽

Vol 29 (1) ◽

pp. 11-17

Author(s):

Nicola Corradi ◽

Gaetano Caruso ◽

Ilaria Martini ◽

Leo Massari

Keyword(s):

Case Report ◽

Humeral Shaft ◽

Humeral Shaft Nonunion

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405 Radiological Analysis of Gentamicin Eluting Synthetic Bone Graft Substitute Used in The Management of Gustilo IIIB Open Fractures

British Journal of Surgery ◽

10.1093/bjs/znab134.273 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

A Aljawadi ◽

I Madhi ◽

T Naylor ◽

M Elmajee ◽

A Islam ◽

...

Keyword(s):

Bone Graft ◽

Cortical Thickness ◽

Bone Graft Substitute ◽

Fracture Site ◽

Open Fractures ◽

X Rays ◽

Radiographic Images ◽

Synthetic Bone ◽

Synthetic Bone Graft

Abstract Background Management of traumatic bone void associated with Gustilo IIIB open fractures is challenging. Gentamicin eluting synthetic bone graft substitute (Cerament-G) had been recently utilised for the management of patients with these injuries. This study aims to assess radiological signs of Cerament-G remodelling. Method Retrospective data analysis of all patients admitted to our unit with IIIB open fractures who had Cerament-G applied as avoid filler. Postoperative radiographic images of the fracture site at 6-weeks, 3-months, 6-months and at the last follow-up were reviewed. The radiological signs of Cerament-G integration, percent of void healing, and bone cortical thickness at the final follow-up were assessed. Results 34 patients met our inclusion criteria, mean age: 42 years. Mean follow-up time was 20 months. 59% of patients had excellent (>90%) void filling, 26.4% of patients had 50-90% void filling, and 14.6% had < 50% void filling. Normal bone cortical thickness was restored on AP and Lateral views in 55.8% of patients. No residual Cerement-G was seen on X-rays at the final follow-up in any of the patients. Conclusions Our results showed successful integration of Cerament-G with excellent void filling and normal cortical thickness achieved in more than half of the patients.

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Versatility of the pedicled buccal fat pad flap for the management of oroantral fistula: a retrospective study of 25 cases

Maxillofacial Plastic and Reconstructive Surgery ◽

10.1186/s40902-019-0229-x ◽

2019 ◽

Vol 41 (1) ◽

Cited By ~ 3

Author(s):

Jinyoung Park ◽

Byung-do Chun ◽

Uk-Kyu Kim ◽

Na-Rae Choi ◽

Hong-Seok Choi ◽

...

Keyword(s):

Bone Graft ◽

Graft Failure ◽

Fistula Closure ◽

Fat Pad ◽

Buccal Fat Pad ◽

Dental Surgery ◽

Female Ratio ◽

Maxillary Bone ◽

Oroantral Fistula

Abstract Purpose Maxillary bone grafts and implantations have increased over recent years despite a lack of maxillary bone quality and quantity. The number of patients referred for oroantral fistula (OAF) due to implant or bone graft failure has increased, and in patients with an oroantral fistula, the pedicled buccal fat pad is viewed as a robust, reliable option. This study was conducted to document the usefulness of buccal fat pad grafts for oroantral fistula closure. Materials and methods We retrospectively studied 25 patients with OAF treated with a buccal fat pad graft from 2015 to 2018. Sex, age, OAF location, cause, duration, presence of systemic disease, smoking, previous dental surgery, and side effects were investigated. Results A total of 25 patients were studied. Mean patient age was 54.8 years, and the male to female ratio was 19:6. Causes of oroantral fistula were cyst enucleation, tumor resection, implant removal, bone graft failure, and extraction. Excellent results were obtained in 23 (92%) of the 25 patients. In the other two patients that both smoked, a small fistula was observed during follow-up. No recurrence of oroantral fistula was observed after 2 months to 1 year of follow-up. Conclusions The incidence of oroantral fistula is increasing due to implant and bone graft failures. Oroantral fistula closure using a pedicled buccal fat pad was found to have a high success rate.

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Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate

The Cleft Palate-Craniofacial Journal ◽

10.1177/10556656211025197 ◽

2021 ◽

pp. 105566562110251

Author(s):

Vijay Kumar ◽

Vidya Rattan ◽

Sachin Rai ◽

Satinder Pal Singh ◽

Jai Kumar Mahajan

Keyword(s):

Bone Graft ◽

Iliac Crest ◽

Demineralized Bone Matrix ◽

Bone Matrix ◽

Volumetric Analysis ◽

Group I ◽

Alveolar Bone Grafting ◽

Group Ii ◽

Demineralized Bone

Objective: Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of radiological and clinical outcomes. Design: Prospective, randomized, parallel groups, double-blind, controlled trial. Setting: Unit of Oral and Maxillofacial Surgery, Oral Health Science Centre, Postgraduate Institute of Medical Education & Research, Chandigarh. Participants: Twenty patients with UCLP. Interventions: Patients were allocated into group I (Iliac crest bone graft) and group II (DMBM) for SABG. Outcomes were assessed at 2 weeks, 6 months, and then after mean follow-up period of 63 months. Outcomes Measures: Volumetric analysis of the grafted bone in the alveolar cleft site was done through cone beam computed tomography using Cavalieri principle and modified assessment tool. Clinical assessment was performed in terms of pain, swelling, duration of hospital stay, cost of surgery, alar base symmetry, and donor site morbidity associated with iliac crest harvesting. Results: Volumetric analysis through Cavalieri principle revealed comparable bone uptake at follow-up of 6 months between group I (70%) and group II (69%). Modified assessment tool showed no significant difference between horizontal and vertical bone scores over short- and long-term follow-up. In group II, there was higher cost of surgery, but no donor site morbidity unlike group I. Conclusions: Demineralized bone matrix proved analogous to iliac crest bone graft as per volumetric analysis over shorter period. However, although statistically insignificant, net bone volume achieved was lower than the iliac crest graft at longer follow-up.

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