Calcaneal reconstruction using a femoral head allograft and biologic adjuncts: A case report

Weiss, Matthew B; Konopka, Jaclyn A.; Azam, Mohammad T.; Ubillus, Hugo A; Mercer, Nathaniel P.; Kennedy, John G.

doi:10.1177/2050313x221129782

Cited by 3 publications

(2 citation statements)

References 42 publications

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“…The femur head allograft is a corticocancellous structural bone graft, and among the most used bone allografts. Its application in foot and ankle surgery has been reported mostly for arthrodesis procedures, whereas literature is sparse as regards its use for the reconstruction of calcaneal bone loss [12][13][14][15] . Loder et al and Weiss et al reported successful delayed calcaneal reconstructions with femur head allografts in two patients who developed post-traumatic osteomyelitis following ORIF treatment requiring calcaneal resections.…”

Section: Discussionmentioning

confidence: 99%

Calcaneal Hybrid Reconstruction With Femur Head Allograft Enriched With Bone Marrow and Alt Flap

Longo,

Giacalone,

Iundusi

et al. 2023

PRRS

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Open calcaneal fractures with bone and soft tissue loss often require complex reconstructive strategies aimed at restoring the hind-foot anatomy and physiologic ambulation. Although there is no established gold standard for treatment, the techniques utilized include bone autografts and allografts, composite flaps, and prosthesis. We report the case of a 43-year-old healthy man, who suffered an open fracture of the right calcaneus with bone loss and a wide soft tissue defect, following a motorcycle accident. After the emergency management, a reconstruction with a femur head allograft and free anterolateral thigh flap (ALT) was planned. The allograft was shaped with the aid of 3D-printed models of the defect and residual calcaneal bone. Concentrated bone marrow aspirate (cBMA) was utilized as a biological adjunct to promote osteointegration by enhancing new bone formation. The soft tissue defect was reconstructed with an anterolateral thigh flap (ALT), harvested from the contralateral thigh, and anastomosed with the posterior tibial vessels. Off-label treatment with Teriparatide was initiated postoperatively, to further boost the healing process. The reconstruction was successful, with full weight bearing reached at 6 post-operative months, and no reported complications over the 8 months follow-up.

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Section: Discussionmentioning

confidence: 99%

Calcaneal Hybrid Reconstruction With Femur Head Allograft Enriched With Bone Marrow and Alt Flap

Longo,

Giacalone,

Iundusi

et al. 2023

PRRS

View full text Add to dashboard Cite

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“…However, patients who have undergone complex traumatic injuries may develop demineralization, loss of bone mass, and decreased skeletal integrity, so-called post-traumatic osteoporosis (PTO) [1][2][3]. Advances in intensive care medicine have contributed to the increased survival of patients with previously terminal traumatic injuries, including those with polytraumas from high energy collision, burns, explosions, crush injuries, falls from height, and catastrophic events-increasing the incidence of this progressively debilitating pathology [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Navigating Post-Traumatic Osteoporosis: A Comprehensive Review of Epidemiology, Pathophysiology, Diagnosis, Treatment, and Future Directions

Weiss,

Syed,

Whiteson

et al. 2024

Life

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Post-traumatic osteoporosis (PTO) presents a significant challenge in clinical practice, characterized by demineralization and decreased skeletal integrity following severe traumatic injuries. This literature review manuscript addresses the knowledge gaps surrounding PTO, encompassing its epidemiology, pathophysiology, risk factors, diagnosis, treatment, prognosis, and future directions. This review emphasizes the complexity of the etiology of PTO, highlighting the dysregulation of biomineralization processes, inflammatory cytokine involvement, hormonal imbalances, glucocorticoid effects, vitamin D deficiency, and disuse osteoporosis. Moreover, it underscores the importance of multidisciplinary approaches for risk mitigation and advocates for improved diagnostic strategies to differentiate PTO from other musculoskeletal pathologies. This manuscript discusses various treatment modalities, including pharmacotherapy, dietary management, and physical rehabilitation, while also acknowledging the limited evidence on their long-term effectiveness and outcomes in PTO patients. Future directions in research are outlined, emphasizing the need for a deeper understanding of the molecular mechanisms underlying PTO and the evaluation of treatment strategies’ efficacy. Overall, this review provides a comprehensive overview of PTO and highlights avenues for future investigation to enhance clinical management and patient outcomes.

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Modified Calcanization of Tibia for Hindfoot Defect Reconstruction: Method and Preliminary Results

Zhang,

Wang,

Liu

et al. 2024

Orthopaedic Surgery

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ObjectivesTo introduce our modified technique for calcanization of the tibia in managing massive bony loss of hindfoot and preliminary outcomes.MethodsFrom January 2015 to December 2021, modified calcanization of the tibia were performed in 10 patients with unilateral loss of the calcaneus. Clinical outcomes were assessed based on the American Orthopaedic Foot & Ankle Society score and Symptom Checklist‐90‐Revised questionnaire. Paired two‐group t‐test was applied to compare the parameters.ResultsThe mean lengthened length of the tibia was 77.3 ± 3.0 mm (range, 74–83 mm). The mean external fixation time was 123.7 ± 52.1 days (range, 117–134 days) and the mean external fixation index was 1.601 ± 0.046 days/mm. All patients stuck to the postoperative follow‐up plan with an average follow‐up time of 29.7 ± 3.4 months (range, 24–35 months). Deformities of the injured limbs were well corrected. Based on American Orthopaedic Foot & Ankle Society score, eight good and two fair results were achieved. The mental status of all patients was within the normal range, and several indices of the Symptom Checklist‐90‐Revised questionnaire of each patient were improved after the whole procedure.ConclusionWe demonstrate that the modified calcanization of the tibia is qualified for total loss of calcaneus with limited complications. Early rehabilitation is attainable since external fixation time is shortened due to a simplified procedure.

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Calcaneal reconstruction using a femoral head allograft and biologic adjuncts: A case report

Cited by 3 publications

References 42 publications

Calcaneal Hybrid Reconstruction With Femur Head Allograft Enriched With Bone Marrow and Alt Flap

Calcaneal Hybrid Reconstruction With Femur Head Allograft Enriched With Bone Marrow and Alt Flap

Navigating Post-Traumatic Osteoporosis: A Comprehensive Review of Epidemiology, Pathophysiology, Diagnosis, Treatment, and Future Directions

Modified Calcanization of Tibia for Hindfoot Defect Reconstruction: Method and Preliminary Results

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