scholarly journals Folded Free Vascularized Fibular Bone Graft for Segmental Femoral Bone Defect: a Retrospective Report

2021 ◽  
Author(s):  
Yifan Wu ◽  
Chao Jian ◽  
Baiwen Qi ◽  
Zonghuan Li ◽  
Aixi Yu
Keyword(s):  
Bone Graft ◽  
Bone Defect ◽  
Clinical Data ◽  
External Fixators ◽  
Imaging Data ◽  
Femoral Bone ◽  
Fixation Failure ◽  
Time Operation ◽  
Segmental Bone

Abstract ObjectiveVascularized fibular bone graft is an efficient method for various segmental bone defects. The objective of this report is to introduce our experience of folded free vascularized fibular bone graft for segmental femoral bone defect.Patients and methodsClinical data collected by surgeons and Hospital Information System (HIS) system were screened respectively. Cases with segmental femoral bone defect repaired by folded free vascularized fibular bone graft were collected. Clinical data including demographic characteristics, defect size, coinfection, perioperative treatment and imaging data during follow up were all collected for analysis.ResultsTwelve patients (10 males and 2 females), aged from 6 to 58, were included in this report. The defect range was 3 to 10 cm, with an average of 6.2 cm. Three cases were complicated with infection, the others were not. Folded free vascularized fibular bone graft were harvested for the reconstruction of segmental femoral bone defect. The grafts were fixed with plates in 9 cases and external fixators in 3 cases. All grafts healed uneventfully with an average healing time of 5.2 months (range 4~8 months). Internal fixation failure occurred in one case. The follow up time ranged from 15 to 130 months (average 58.3 months).ConclusionFolded free fibula graft is one of the optional methods for segmental bone defect of femur. Through this method, patients can achieve one-time operation to reconstruct the bone defect of the affected limb.

scholarly journals Folded Free Vascularized Fibular Bone Graft for Segmental Femoral Bone Defect: a Retrospective Report

2021 ◽  
Author(s):  
Yifan Wu ◽  
Chao Jian ◽  
Baiwen Qi ◽  
Zonghuan Li ◽  
Aixi Yu
Keyword(s):  
Bone Graft ◽  
Bone Defect ◽  
Clinical Data ◽  
External Fixators ◽  
Imaging Data ◽  
Femoral Bone ◽  
Fixation Failure ◽  
Time Operation ◽  
Segmental Bone

Abstract ObjectiveVascularized fibular bone graft is an efficient method for various segmental bone defects. The objective of this report is to introduce our experience of folded free vascularized fibular bone graft for segmental femoral bone defect.Patients and methodsClinical data collected by surgeons and Hospital Information System (HIS) system were screened respectively. Cases with segmental femoral bone defect repaired by folded free vascularized fibular bone graft were collected. Clinical data including demographic characteristics, defect size, coinfection, perioperative treatment and imaging data during follow up were all collected for analysis.ResultsTwelve patients (10 males and 2 females), aged from 6 to 58, were included in this report. The defect range was 3 to 10 cm, with an average of 6.2 cm. Three cases were complicated with infection, the others were not. Folded free vascularized fibular bone graft were harvested for the reconstruction of segmental femoral bone defect. The grafts were fixed with plates in 9 cases and external fixators in 3 cases. All grafts healed uneventfully with an average healing time of 5.2 months (range 4~8 months). Internal fixation failure occurred in one case. The follow up time ranged from 15 to 130 months (average 58.3 months).ConclusionFolded free fibula graft is one of the optional methods for segmental bone defect of femur. Through this method, patients can achieve one-time operation to reconstruct the bone defect of the affected limb.

scholarly journals Combined tibial lengthening and ankle arthrodesis for patients with certain type of sequelae of poliomyelitis

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668441
Author(s):  
Chi-Chuan Wu
Keyword(s):  
Bone Graft ◽  
Functional Disability ◽  
Muscle Power ◽  
Ankle Arthrodesis ◽  
Bone Graft Substitute ◽  
Modern Medicine ◽  
External Fixators ◽  
Lesion Side ◽  
Gait Function

Purpose: Following far advancement of modern medicine and technology, functional disability in a certain type of sequelae of poliomyelitis may be effectively improved. Methods: Eight consecutive adult patients with unilateral sequelae of poliomyelitis were treated. These patients had shortened lower extremity of an average of 4.8 cm (range, 4.0–5.5 cm) in the lesion side. Muscle power of the ipsilateral knee was nearly intact (grade 4 or 5) but the ankle extension was completely flaccid. The tibia was osteotomized and lengthened with external fixation. Consequently, all external fixators were converted to plates supplemented with autogenous corticocancellous bone graft and bone graft substitute. Ankle arthrodesis was performed concomitantly. Results: Seven patients were followed up for an average of 3.7 years (range, 2.2–5.4 years). All seven lengthened sites healed with an average union time of 3.9 months (range, 3.5–4.5 months) after plating. One ankle infection occurred. Gait function significantly improved by modified Mazur scoring evaluation ( p = 0.02). At the latest follow-up, all patients had a minimal or unnoticed limp in level walking. Conclusion: The described combined techniques may be an excellent alternate for treating selected patients with sequelae of poliomyelitis. The procedure is not complex but the efficiency is extremely prominent.

Reconstruction of posttraumatic long bone defect with free vascularized bone graft: Good outcome in 48 patients with 6 years' follow-up

2001 ◽  
Vol 72 (4) ◽  
pp. 359-364 ◽  
Author(s):  
Yuan-Kun Tu ◽  
Cheng-Yo Yen ◽  
Wen-Lin Yeh ◽  
I-Chun Wang ◽  
Kun-Chang Wang ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Defect ◽  
Long Bone ◽  
Vascularized Bone Graft ◽  
Good Outcome ◽  
Long Bone Defect ◽  
Vascularized Bone

scholarly journals Large segmental defects in midshaft clavicle nonunion treated with autologous tricortical iliac crest bone graft

2021 ◽  
pp. 175857322110648
Author(s):  
Fleur AE van der Burg ◽  
Thomas PA Baltes ◽  
Peter Kloen
Keyword(s):  
Internal Fixation ◽  
Bone Graft ◽  
Bone Defect ◽  
Literature Search ◽  
Iliac Crest ◽  
Defect Size ◽  
Iliac Crest Bone Graft ◽  
Extensive Literature ◽  
Dash Score ◽  
Segmental Bone

Background To evaluate the use of intercalary iliac crest bone graft in the treatment of clavicle nonunion with a large segmental bone defect (3–6 cm). Methods This retrospective study evaluated patients with large segmental bone defects (3–6 cm) after clavicle nonunion, treated with open reposition internal fixation and iliac crest bone graft between February 2003 and March 2021. At follow-up the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was administered. A literature search was performed to provide an overview of commonly used graft types per defect size. Results We included five patients treated with open reposition internal fixation and iliac crest bone graft for clavicle nonunion with a median defect size of 3.3 cm (range 3–6 cm). Union was achieved in all five, and all pre-operative symptoms resolved. The median DASH score was 23 out of 100 (IQR 8-24). An extensive literature search revealed that there are no studies describing the use of an used iliac crest graft for defects larger than 3 cm. Instead, a vascularized graft was typically used to treat defects sizes between 2.5 and 8 cm. Discussion An autologous non-vascularized iliac crest bone graft can be safely used and is reproducible to treat a midshaft clavicle non-union with a bone defect between 3 and 6 cm.

scholarly journals How to select the fusion and fixation range of thoracolumbar and lumbar tuberculosis: A retrospective clinical study

2020 ◽  
Author(s):  
Yang zong qiang ◽  
Liu chang hao ◽  
Niu ning kui ◽  
Tang jing ◽  
Sayed Abdulla Jami ◽  
...  
Keyword(s):  
Bone Graft ◽  
Clinical Efficacy ◽  
Clinical Data ◽  
Spinal Tuberculosis ◽  
Operation Time ◽  
Adjacent Vertebral Body ◽  
Surgery Group ◽  
Surgical Methods ◽  
Retrospective Clinical Study

Abstract Purpose To investigate the clinical data of thoracolumbar and lumbar spinal tuberculosis with diseased and non-diseased intervertebral surgery, evaluate the clinical efficacy of the two surgical methods, and explore how to choose the fusion of fixation range. Methods Among 221 patients with thoracolumbar and lumbar tuberculosis were categorized into two groups. 118 patients were in the diseased intervertebral surgery group (lesion vertebral pedicle fixation, group A) and there were 103 patients in the non-diseased intervertebral surgery group (1 or 2 vertebral fixation groups at the above and below levels of the affected vertebra, group B). Both groups of patients were treated with primary or staging, anterior combined complete lesion removal, bone graft fusion, and internal fixation. By analyzing of clinical data and the clinical efficacy of the two surgical methods in thoracolumbar and lumbar tuberculosis was evaluated. Results The mean follow-up duration was 65months (range 50–68 months). There were no significant differences in laboratory examination, VAS scores, and the Cobb angle correction rate and the angle loss, however, significant differences between the two groups in operation time, blood loss, drainage volume, and transfusion, the diseased intervertebral surgery group was significantly better than the non-diseased intervertebral surgery group. Meanwhile, the bone graft was fused entirely at the last follow-up. Conclusion Under the conditions of strictly grasping the indications for surgery, intervertebral surgery for thoracolumbar and lumbar tuberculosis is safe, effective, and feasible, and it can effectively restore its physiological curvature and reduce the degeneration of the adjacent vertebral body.

scholarly journals An innovate strategy to treat large metaphyseal segmental femoral bone defect using customized design and 3D printed micro-porous prosthesis: a prospective clinical study

2020 ◽  
Author(s):  
Guojin Hou ◽  
Bingchuan Liu ◽  
Yun Tian ◽  
Zhongjun Liu ◽  
Fang Zhou ◽  
...  
Keyword(s):  
Bone Defect ◽  
Weight Bearing ◽  
Fibrous Tissue ◽  
Radiographic Evaluation ◽  
Full Weight Bearing ◽  
Prospective Clinical Study ◽  
Femoral Bone ◽  
3D Printed ◽  
Partial Weight

Abstract Background Large segmental bone defect at the metaphyseal area is still difficult to treat, nowadays, there is a tremendous level of interest in uses of 3D printing technology in orthopaedic surgery. This study was introduced to prospectively confirm the safety and effectiveness of 3D printed micro-porous prosthesis in clinical bone defect reconstruction application. Methods Patients with segmental irregular-shaped bone defect of the femur were recruited from 2017.12 to 2018.11. The first stage of the treatment involves radical debridement of all infected or non-viable bone and interposed fibrous tissue, and temporary fixation. Once the culture and biopsy results were negative, the PMMA spacer should remain in the defect approximately 6-8 weeks. This period is for the membrane formation, virtual surgery (computed tomography (CT) scan of the lesion area and the contra-lateral parts of the femur, and then design of the implant). The second stage involves reconstruction the defects with the 3D printed micro-porous prosthesis combined with intra-medullar nailwithout bone graft.Routine clinical follow-up and radiographic evaluation were done to assess bone incorporation and complications of internal fixation. The weight-bearing time and the joint function were recorded. Result 5 consecutive patients were included in the study. They were followed up for an average of 16.4 months. The average length of bone defect and the distal residual bone was 12 cm and 6.5 cm. The average time of partial weight-bearing and full weight-bearing was 12.7 days and 2.6 months. X-ray demonstrated good osseous integration of the implant/bone interface. No complications occurred such as implant loosening, subsidence, loss of correctionand infection. At the last follow-up, Harris score of hip joint was excellent in 2 cases, good in 2 cases, fair in 1 case; HSS score of knee joint was good in 4 cases, middle in 1 case. Conclusion Meticulous customized design 3D printed micro-porous prosthesis combined with intramedullary fixation may be a cost-effective and an alternative strategy to treat metaphyseal segmental irregular-shaped femoral bone defect without bone graft, especially for cases with massive juxta-articular bone loss.

scholarly journals Safety and efficacy of a novel retrograde route for femoral bone graft harvesting by Reamer-Irrigator-Aspirator: a pilot study on 24 patients

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Fernando Bidolegui ◽  
Sebastián Pereira ◽  
Cristina Irigoyen ◽  
Robinson Esteves Pires
Keyword(s):  
Postoperative Pain ◽  
Bone Graft ◽  
Iliac Crest ◽  
Bone Defects ◽  
Femoral Bone ◽  
Femoral Route ◽  
Bone Graft Harvesting ◽  
Post Traumatic ◽  
Graft Volume

Abstract Background The Reamer–Irrigator–Aspirator system was initially developed to reduce fat embolism and thermic necrosis during reamed intramedullary nail fixation of femoral shaft fractures. Currently, this system is used in extended applications including accessing large volume of autologous bone graft, as alternative for iliac crest harvesting. Antegrade femoral bone graft harvesting using the Reamer-Irrigator-Aspirator system is considered the standard technique. The aim of our study is to evaluate the efficacy (bone graft volume) and the complications (blood loss, postoperative pain, and incidence of iatrogenic fractures) of the Reamer–Irrigator–Aspirator system through the retrograde femoral route in a series of patients with post-traumatic bone defects or nonunions. Methods A non-controlled single center retrospective observational cohort study was conducted in a level1 trauma center to evaluate all patients who were treated using the RIA system. Between November 2015 and May 2019, 24 patients (8 women and 16 men; mean age: 41 years [range 27–55 years]) with bone defects or nonunions underwent bone graft harvesting using the Reamer–Irrigator–Aspirator system through retrograde femoral route. Postoperative pain, complications, and bone graft volume were analyzed. Inclusion criteria was patients older than 18 years with a diagnosis of post-traumatic bone defect or associated tibial or femoral nonunion, with minimum 6-months follow, treated using the RIA. We hypothesized that the retrograde route of the RIA system is a safe and efficacious method for bone harvesting. Results The average volume of collected graft was 45 cc (range 30–60 cc). In 83% of the cases, bone grafting was sufficient, while in 17% it was necessary to add iliac crest bone graft to completely fill the bone defect. A mean drop in postoperative hemoglobin of 4.1 g / dL (range 0.5–6.0 g / dL) was evidenced. In 4 cases (33%), a unit of packed red blood cells was required. Regarding postoperative pain, visual analogue scale after 3 months postoperatively was 1.6 in average. After 6 months, the value has decreased to 0.4. There were no perioperative or postoperative complications at 6-month follow-up. Conclusion In this limited case series, large volumes of bone graft were harvested using the retrograde route of the RIA system and there were no intra-/ postoperative complications observed at 6-month follow-up. Therefore this novel technique appears safe and efficacious. However, it’s important to highlight that future prospective controlled studies are necessary to validate the insights from this pilot study.

scholarly journals Defining giant mandibular ameloblastomas – Is a separate clinical sub-entity warranted?

2018 ◽  
Vol 51 (02) ◽  
pp. 208-215 ◽  
Author(s):  
Aditya V. Kanoi ◽  
Tibar Banerjee ◽  
Narayanamurthy Sundaramurthy ◽  
Arindam Sarkar ◽  
Pooja Kanoi ◽  
...  
Keyword(s):  
Decision Making ◽  
Bone Defect ◽  
Medical Literature ◽  
Inclusion Criteria ◽  
Segmental Bone Defect ◽  
Exclusion Criteria ◽  
The Past ◽  
Mandibular Segment ◽  
Segmental Bone

ABSTRACT Context: The term giant mandibular ameloblastoma (GMAs) while being in popular usage in the medical literature remains largely equivocal. Although a few authors have in the past attempted to ascribe definite criteria to this entity, these are by and large arbitrary and without any benefit in decision-making or contributing to its management. Aims: The aim of this study is to propose a set of objective criteria for GMAs that can be clinically correlated and thereby aid in the management of this entity. Patients and Methods: Of a total of 16 patients with ameloblastoma of the mandible presenting at our institute from August 2012 to September 2016, 11 patients were identified as having GMAs as per the criteria proposed. Results: The defects in the mandible following segmental resection ranged from 7 to 11.5 cm in length (mean: 9.3 cm). No clinical or radiological evidence of tumour recurrence was found during a mean follow-up period of 10.7 months (range: 2–28 months). Conclusions: Defining GMA based on objective inclusion and exclusion criteria allows segregation of these lesions, thereby helping to remove ambiguity, simplify decision-making and facilitate communication among treating reconstructive surgeons. Inclusion criteria include: (i) The segmental bone defect following resection with a minimum 1 cm margin of healthy bone should exceed 6 cm (ii) The segmental bone defect should involve the central mandibular segment.

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