scholarly journals Experience of using vascularized bone grafts to treat nonunion fractures and limb bone defects

2019 ◽  
Vol 11 (1) ◽  
pp. 9-20
Author(s):  
A. V. Nevedrov ◽  
E. Yu. Shibayev ◽  
V. O. Kalenskiy ◽  
N. N. Zadneprovskiy ◽  
V. B. Shishkin ◽  
...  
Keyword(s):  
Bone Graft ◽  
Three Dimensional ◽  
Bone Grafts ◽  
Bone Defects ◽  
Virtual Planning ◽  
Recipient Site ◽  
Limb Bone ◽  
Bone Nonunion ◽  
Dimensional Printing ◽  
Vascularized Bone

Background.Vascular bone graft transposition is the one of most effective method of nonunion fracture and bone defect treatment. However, the use of this technique is associated with some difficulties. One is the adjustment of recipient bed size and the graft. The other is the difficulty to reconstruct the alignment and length of bone. A promising method of preparing for the vascular bone graft transposition is virtual three-dimensional planning based on computed tomography data and three-dimensional printing templates.The aimwas to summarize our experience in the treatment of bone nonunion and defects with vascular bone autografts using tree-dimensional virtual planning and printing.Material and methods.We analyzed the treatment process and outcomes of 4 patients with limb bone nonunion and 6 patients with bone defects. In all cases, we used vascular bone grafts. Internal fixation of grafts was used in 7 cases, external fixation was used in 3 cases. At preparation stage in 4 cases, we used tree-dimensional virtual surgery planning and printing templates.Results.One case was diagnosed with bone graft necrosis caused by venous thrombosis. Consolidation was achieved in all patients; a late consolidation was observed in 2 cases. Hematoma in donor area was seen in 2 patients. When using three-dimensional virtual planning and tree-dimensional printing templates, the operation time was decreased by 1 hour 5 minutes. We identified two cases of poor reposition in the group without virtual planning. No poor reposition was observed in the cases where tree-dimensional planning was used.Conclusion.Vascularized bone grafts provide an effective method to treat bone defects and nonunion. But the planning of graft and recipient site sizes is associated with certain difficulties. Our preliminary results have shown that virtual three-dimensional planning and printing allow improving the precision of the surgical procedure and decreasing operative time.

Postoperative monitoring of free vascularized bone grafts in reconstruction of bone defects

Microsurgery ◽  
2009 ◽  
Vol 29 (5) ◽  
pp. 401-407 ◽  
Author(s):  
Jenny Pliefke ◽  
Grit Rademacher ◽  
Alexander Zach ◽  
Kai Bauwens ◽  
Axel Ekkernkamp ◽  
...  
Keyword(s):  
Bone Grafts ◽  
Bone Defects ◽  
Postoperative Monitoring ◽  
Reconstruction Of Bone Defects ◽  
Vascularized Bone

Three-dimensional Printing Approaches for the Treatment of Critical-sized Bone Defects

2016 ◽  
pp. 233-278 ◽  
Author(s):  
Sara Salehi ◽  
Bilal A. Naved ◽  
Warren L. Grayson ◽  
Warren L. Grayson ◽  
Warren L. Grayson
Keyword(s):  
Three Dimensional ◽  
Bone Defects ◽  
Three Dimensional Printing ◽  
Dimensional Printing

scholarly journals Author Correction: Repair of bone defects with prefabricated vascularized bone grafts and double-labeled bone marrow-derived mesenchymal stem cells in a rat model

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Xiao-Rui Jiang ◽  
Hui-Ying Yang ◽  
Xin-Xin Zhang ◽  
Guo-Dong Lin ◽  
Yong-Chun Meng ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Rat Model ◽  
Bone Grafts ◽  
Bone Defects ◽  
Vascularized Bone

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Evaluation of Bone Volume after Secondary Bone Grafting in Unilateral Alveolar Cleft Using Computer-Aided Engineering

2014 ◽  
Vol 51 (6) ◽  
pp. 665-668 ◽  
Author(s):  
Hayato Nagashima ◽  
Yoshiaki Sakamoto ◽  
Hisao Ogata ◽  
Junpei Miyamoto ◽  
Masaki Yazawa ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Bone Graft ◽  
Bone Grafting ◽  
Three Dimensional ◽  
Bone Grafts ◽  
Bone Volume ◽  
Computer Aided Engineering ◽  
Alveolar Cleft ◽  
Alveolar Bone Grafting ◽  
Computer Aided

The purpose of this study was to evaluate the initial defect and the outcome of bone grafts for unilateral alveolar cleft. To determine the absorption of the bone graft in patients with unilateral cleft, computer-aided engineering (CAE) with multi-detector row computed tomography (MDCT) was used. MDCT scans of 29 patients were taken immediately preoperatively and at 1 month and 6 months postoperatively. The patients underwent bone grafting between 8 and 14 years of age using iliac crest bone grafts. Three-dimensional models were created in each period, and the defect at the alveolar cleft and volume of the bone graft were determined in each patient using CAE. Cleft volume and success of alveolar bone grafting were significantly correlated ( P < .01). Alveolar clefts with cleft palate required more bone volume than those without cleft palate ( P < .01), but the resorption rate did not significantly differ between alveolar clefts with and without cleft palate (0.48 ± 0.14 and 0.49 ± 0.18, respectively; P =.93). In conclusion, three-dimensional reconstruction of bone grafts using CAE based on MDCT provides a valuable objective assessment of graft volume.

Evaluation of the Bone Healing Process Utilizing Platelet-Rich Plasma Activated by Thrombin and Calcium Chloride: A Histologic Study in Rabbit Calvaria

2013 ◽  
Vol 39 (1) ◽  
pp. 14-21 ◽  
Author(s):  
Walter Betoni-Junior ◽  
Paula Dechichi ◽  
Jônatas Caldeira Esteves ◽  
Darceny Zanetta-Barbosa ◽  
Aparecido Eurípedes Onório Magalhães
Keyword(s):  
Bone Graft ◽  
Calcium Chloride ◽  
Bone Healing ◽  
Bone Repair ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Bone Defects ◽  
Histomorphometric Analysis ◽  
Histologic Study ◽  
Vascularized Bone

To evaluate the bone healing of defects filled with particulate bone graft in combination with platelet-rich plasma (PRP), added with a mixture of calcium chloride and thrombin or just calcium chloride. Two 5-mm bone defects were created in the calvaria of 24 rabbits. Each defect was filled with particulate bone graft and PRP. In one defect the PRP was activated by a mixture of calcium chloride and thrombin; in the other, PRP was activated by calcium chloride only. The animals were euthanized 1, 2, 4, and 8 weeks after the surgeries, and the calvaria was submitted to histologic processing for histomorphometric analysis. The qualitative analysis has shown that both defects presented the same histologic characteristics so that a better organized, more mature, and well-vascularized bone tissue was noticed in the eighth week. A good bone repair was achieved using either the mixture of calcium chloride and thrombin or the calcium chloride alone as a restarting agent of the coagulation process.

Bone Grafts for Scaphoid Nonunion: An Overview

Hand Surgery ◽  
2015 ◽  
Vol 20 (02) ◽  
pp. 222-227 ◽  
Author(s):  
Steven E.R. Hovius ◽  
Tim de Jong
Keyword(s):  
Surgical Treatment ◽  
Bone Graft ◽  
Bone Grafts ◽  
Good Position ◽  
Vascularized Bone Graft ◽  
Scaphoid Nonunion ◽  
Non Union ◽  
Non Surgical Treatment ◽  
Vascularized Bone

The scaphoid is the most common fractured bone in the wrist. Despite adequate non-surgical treatment, around 10% to 15% of these fractures will not heal. Untreated scaphoid non-union can cause a scaphoid non-union advance collapse (SNAC), this is a progressive deformity and can cause degenerative changes in the wrist. Surgery is focused on achieving consolidation, pain reduction and a good position of the scaphoid while preventing osteoarthritis in the long-term. Surgery consists of reduction and fixation of the scaphoid with a non-vascularized or vascularized bone graft. An overview of the most used vascularized and non-vascularized bone grafts and their indications are presented.

scholarly journals Vascularized bone grafts for post-traumatic defects in the upper extremity

2021 ◽  
Vol 48 (1) ◽  
pp. 84-90
Author(s):  
Giovanna Petrella ◽  
Daniele Tosi ◽  
Filippo Pantaleoni ◽  
Roberto Adani
Keyword(s):  
Upper Extremity ◽  
Bone Grafting ◽  
Femoral Condyle ◽  
Bone Grafts ◽  
Bone Defects ◽  
Tissue Loss ◽  
Surgical Reconstruction ◽  
Non Union ◽  
Post Traumatic ◽  
Vascularized Bone

Vascularized bone grafts (VBGs) are widely employed to reconstruct upper extremity bone defects. Conventional bone grafting is generally used to treat defects smaller than 5–6 cm, when tissue vascularization is adequate and there is no infection risk. Vascularized fibular grafts (VFGs) are mainly used in the humerus, radius or ulna in cases of persistent non-union where traditional bone grafting has failed or for bone defects larger than 6 cm. Furthermore, VFGs are considered to be the standard treatment for large bone defects located in the radius, ulna and humerus and enable the reconstruction of soft-tissue loss, as VFGs can be harvested as osteocutaneous flaps. VBGs enable one-stage surgical reconstruction and are highly infection-resistant because of their autonomous vascularization. A vascularized medial femoral condyle (VFMC) free flap can be used to treat small defects and non-unions in the upper extremity. Relative contraindications to these procedures are diabetes, immunosuppression, chronic infections, alcohol, tobacco, drug abuse and obesity. The aim of our study was to illustrate the use of VFGs to treat large post-traumatic bone defects and osteomyelitis located in the upper extremity. Moreover, the use of VFMC autografts is presented.

scholarly journals Exosomes in the Repair of Bone Defects: Next-Generation Therapeutic Tools for the Treatment of Nonunion

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Jian Lu ◽  
Qi-Yang Wang ◽  
Jia-Gen Sheng
Keyword(s):  
Bone Graft ◽  
Bone Metabolism ◽  
Cell Communication ◽  
Bone Grafts ◽  
Bone Defects ◽  
Long Bone ◽  
Safety Issues ◽  
Cell Based Therapy ◽  
Bone Graft Substitutes ◽  
Autologous Bone Grafts

Nonunion with bone defects, a common complication after long bone fracture, is a major challenge for orthopaedic surgeons worldwide because of the high incidence rate and difficulties in achieving successful treatment. Bone defects are the main complications of nonunion. The conventional biological treatments for nonunion with bone defects involve the use of autologous bone grafts or bone graft substitutes and cell-based therapy. Traditional nonunion treatments have always been associated with safety issues and various other complications. Bone grafts have limited autologous cancellous bone and there is a risk of infection. Additionally, problems with bone graft substitutes, including rejection and stimulation of bone formation, have been noted, and the health of the stem cell niche is a major consideration in cell-based therapy. In recent years, researchers have found that exosomes can be used to deliver functional RNA and mediate cell-to-cell communication, suggesting that exosomes may repair bone defects by regulating cells and cytokines involved in bone metabolism. In this review, we highlight the possible relationships between risk factors for nonunion and exosomes. Additionally, we discuss the roles of exosomes in bone metabolism and bone regeneration.

scholarly journals Vascularized Bone Grafts in Spinal Reconstruction: An Overview of Nomenclature and Indications

2021 ◽  
Vol 35 (01) ◽  
pp. 050-053
Author(s):  
Anna J. Skochdopole ◽  
Ryan D. Wagner ◽  
Matthew J. Davis ◽  
Sarth Raj ◽  
Sebastian J. Winocour ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Reconstruction Algorithm ◽  
Bone Grafts ◽  
Separate Entity ◽  
Recipient Site ◽  
Spinal Reconstruction ◽  
Feeding Vessels ◽  
Microsurgical Techniques ◽  
Reconstructive Algorithm ◽  
Vascularized Bone

AbstractSeveral vascularized bone grafts (VBGs) have been introduced for reconstruction and augmenting fusion of the spine. The expanding use of VBGs in the field of spinoplastic reconstruction, however, has highlighted the need to clarify the nomenclature for bony reconstruction as well as establish the position of VBGs on the bony reconstructive algorithm. In the current literature, the terms “flap” and “graft” are often applied inconsistently when describing vascularized bone transfer. Such inconsistency creates barriers in communication between physicians, confusion in interpreting the existing studies, and difficulty in comparing surgical techniques. VBGs are defined as bone segments transferred on their corresponding muscular attachments without a named major feeding vessel. The bone is directly vascularized by the muscle attachments and unnamed periosteal feeding vessels. VBGs are best positioned as a separate entity in the bony reconstruction algorithm between nonvascularized bone grafts (N-VBGs) and bone flaps. VBGs offer numerous advantages as they supply fully vascularized bone to the recipient site without the microsurgical techniques or pedicle dissection required for raising bone flaps. Multiple VBGs have been introduced in recent years to optimize these benefits for spinoplastic reconstruction.

Sign in / Sign up

Export Citation Format

Share Document