Application of Multiple Wrapped Cancellous Bone Graft Methods for Treatment of Segmental Bone Defects

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2019 Jul 29

PMID 31351451

Citations 3

Authors

Yunhong Ma

Sanjun Gu

Qudong Yin

Haifeng Li

Yongwei Wu

Zihong Zhou

Dehong Feng

Yongjun Rui

Affiliations

Soon will be listed here.

Abstract

Background: The aims of this study were to discuss the principle, therapeutic effect and influencing factors of multiple wrapped cancellous bone graft methods for treatment of segmental bone defects.

Methods: This study retrospectively analyzed the therapeutic effect of different wrapped autologous cancellous bone graft techniques on 51 patients aged (34.5 ± 11.5) years with segmental bone defects. Cancellous bones were wrapped with titanium mesh (n = 9), line mesh (n = 10), line suturing or line binding cortical block, (n = 13), or induced membrane (n = 19). The bone defeats were as follows: tibia (n = 23), radial bone (n = 10), humerus (n = 8), ulnar bone (n = 7), and femur (n = 3). The defect lengths were (5.9 ± 1.1) cm. The functionary recovery of adjacent joint was evaluated by the Paley's method and DASH, respectively.

Results: The incision healed by first intention in 48 cases and secondary healing in 3 cases. All patients were followed up for 19.1 ± 7.1 (12-48) months. Other than one patient with nonunion who received a secondary bone graft, all the patients were first intention of bone healing (the healing rate was 98.0%). The healing time was 6.1 ± 2.1 (3-15) months. There were no significant differences in the healing time among the 4 groups (χ = 1.864, P = 0.601). The incidence of complications in the grafted site was 11.8%, whereas it was 21.6% in the harvest site. At the last follow-up, all the patients had recovered and were able to engage in weight-bearing activities. The functional recovery was good to excellent in 78.4% of cases, there were no significant difference among the 4 groups (χ = 5.429, P = 0.143).

Conclusions: Wrapped cancellous bone grafting is a modified free bone graft method that can be used in the treatment of small and large segmental bone defects as it prevents loosening and bone absorption after bone grafting. The effect of bone healing is related with the quality and quantity of grafted bone, stability of bone defects, property of wrapping material and peripheral blood supply.

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References

Cobos J, Lindsey R, Gugala Z . The cylindrical titanium mesh cage for treatment of a long bone segmental defect: description of a new technique and report of two cases. J Orthop Trauma. 2000; 14(1):54-9. DOI: 10.1097/00005131-200001000-00011. View

Masquelet A, Fitoussi F, Begue T, Muller G . [Reconstruction of the long bones by the induced membrane and spongy autograft]. Ann Chir Plast Esthet. 2000; 45(3):346-53. View

Baron M, Haas R, Dortbudak O, Watzek G . Experimentally induced peri-implantitis: a review of different treatment methods described in the literature. Int J Oral Maxillofac Implants. 2000; 15(4):533-44. View

Ostermann P, Haase N, Rubberdt A, Wich M, Ekkernkamp A . Management of a long segmental defect at the proximal meta-diaphyseal junction of the tibia using a cylindrical titanium mesh cage. J Orthop Trauma. 2002; 16(8):597-601. DOI: 10.1097/00005131-200209000-00010. View

Attias N, Lehman R, Bodell L, Lindsey R . Surgical management of a long segmental defect of the humerus using a cylindrical titanium mesh cage and plates: a case report. J Orthop Trauma. 2005; 19(3):211-6. DOI: 10.1097/00005131-200503000-00011. View

Attias N, Lindsey R . Case reports: management of large segmental tibial defects using a cylindrical mesh cage. Clin Orthop Relat Res. 2006; 450:259-66. DOI: 10.1097/01.blo.0000223982.29208.a4. View

Lindsey R, Gugala Z, Milne E, Sun M, Gannon F, Latta L . The efficacy of cylindrical titanium mesh cage for the reconstruction of a critical-size canine segmental femoral diaphyseal defect. J Orthop Res. 2006; 24(7):1438-53. DOI: 10.1002/jor.20154. View

Clements J, Carpenter B, Pourciau J . Treating segmental bone defects: a new technique. J Foot Ankle Surg. 2008; 47(4):350-6. DOI: 10.1053/j.jfas.2008.04.006. View

Bullens P, Schreuder H, de Waal Malefijt M, Verdonschot N, Buma P . Is an impacted morselized graft in a cage an alternative for reconstructing segmental diaphyseal defects?. Clin Orthop Relat Res. 2009; 467(3):783-91. PMC: 2635451. DOI: 10.1007/s11999-008-0686-5. View

10.

McCall T, Brokaw D, Jelen B, Scheid D, Scharfenberger A, Maar D . Treatment of large segmental bone defects with reamer-irrigator-aspirator bone graft: technique and case series. Orthop Clin North Am. 2009; 41(1):63-73. DOI: 10.1016/j.ocl.2009.08.002. View

11.

Segal U, Shani J . Surgical management of large segmental femoral and radial bone defects in a dog: through use of a cylindrical titanium mesh cage and a cancellous bone graft. Vet Comp Orthop Traumatol. 2009; 23(1):66-70. DOI: 10.3415/VCOT-09-04-0047. View

12.

Apard T, Bigorre N, Cronier P, Duteille F, Bizot P, Massin P . Two-stage reconstruction of post-traumatic segmental tibia bone loss with nailing. Orthop Traumatol Surg Res. 2010; 96(5):549-53. DOI: 10.1016/j.otsr.2010.02.010. View

13.

Cox G, Jones E, McGonagle D, Giannoudis P . Reamer-irrigator-aspirator indications and clinical results: a systematic review. Int Orthop. 2011; 35(7):951-6. PMC: 3167404. DOI: 10.1007/s00264-010-1189-z. View

14.

Karger C, Kishi T, Schneider L, Fitoussi F, Masquelet A . Treatment of posttraumatic bone defects by the induced membrane technique. Orthop Traumatol Surg Res. 2012; 98(1):97-102. DOI: 10.1016/j.otsr.2011.11.001. View

15.

Whately C, Abdallah M, Alwatari Y . Management of large segmental tibial defects using locking IM nail and absorbable mesh. BMJ Case Rep. 2013; 2013. PMC: 3736532. DOI: 10.1136/bcr-2013-010480. View

16.

Wong T, Lau T, Li X, Fang C, Yeung K, Leung F . Masquelet technique for treatment of posttraumatic bone defects. ScientificWorldJournal. 2014; 2014:710302. PMC: 3933034. DOI: 10.1155/2014/710302. View

17.

Taylor B, Hancock J, Zitzke R, Castaneda J . Treatment of Bone Loss With the Induced Membrane Technique: Techniques and Outcomes. J Orthop Trauma. 2015; 29(12):554-7. DOI: 10.1097/BOT.0000000000000338. View

18.

Paley D, Herzenberg J, Paremain G, Bhave A . Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg Am. 1997; 79(10):1464-80. DOI: 10.2106/00004623-199710000-00003. View