Locking Versus Standard Plates for Allograft Fixation After Tumor Resection in Children and Adolescents

Background We describe a new method for corrective osteotomy and the fixation of lower limb deformities in children.Methods Following osteotomy, the desired position is obtained and temporarily stabilized using an external fixator. Definitive fixation is performed with a plate and locking screws inserted percutaneously under fluoroscopic guidance. The procedure was performed in 18 segments in 11 patients. Corrections were performed in all planes. Results The mean follow up was 18 months (range 6-36 months). All patients were corrected to within 2°of that which was planned. Union was obtained in 16 segments in ten patients within 6-16 weeks. Conclusions The method was found to be effective for the correction of deformity in the pediatric population. Advantages compared to conventional methods include minimal soft tissue dissection and the ability to adjust the position before definitive fixation.

show abstract

“…Union was achieved in 16/18 segments in a mean time of 12 weeks [6][7][8][9][10][11][12][13][14][15][16].…”

Section: Resultsmentioning

confidence: 99%

Corrective lower limb osteotomies in children using temporary external fixation and percutaneous locking plates

Bar‐On

Becker

Katz

et al. 2009

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

show abstract

“…Additionally three patients developed nonunion in the former group, out of whom two healed after autogenous bone grafting, with the third patient requiring a revision of plate for persistent nonunion 16). Another study from India reported the union time of one-month following fixation of pathologic fracture and 120 days after limb salvage surgery 17).…”

Section: Discussionmentioning

confidence: 99%

Locking Compression Plate in Musculoskeletal Oncology 'a Friend in Need'

2013

View full text Add to dashboard Cite

BackgroundWe are presenting our experience in the use of locking compression plate (LCP) after juxta-articular oncological resections in addition to its use in pathologic fracture.MethodsA retrospective audit of skeletal reconstruction using LCP in 25 cases of long bone tumors was performed from 2008 to 2010. Reconstruction following limb salvage surgery was done in 17 patients and internal fixation of pathological fracture was done in 8 patients. All patients were available for > 12 months of follow-up, and thus assessed for union at the resected ends.ResultsThere were 8 males and 17 females in the study. The average age at the time of surgery was 30 years (range, 9 to 66 years). The minimum follow-up was 12 months (range, 12 to 32 months). All patients except three went on to heal successfully. Complications occurred in those three patients: wound infection in one, nonunion in another, and periprosthetic fracture in the other patient. In the remaining patients, union was achieved at an average of 6.5 months after reconstruction in curative resection and 4.75 months after fixation of pathological fractures.ConclusionsJoint sparing limb salvage surgery was made successfully possible after sekeletal reconstruction with LCP. Its use was also quite effective in pathological fractures with poor bone quality. Use of locking plates for musculoskeletal oncological reconstruction resulted in a good and predictable rate of union.

show abstract

“…23 Interestingly, altering the mechanism of internal fixation when using frozen allografts by using locking plates instead of compression plates has improved clinical success. 24 Vascularized free fibular grafts have been successful in managing allograft fractures after limb salvage surgery for malignant bone tumors. 25 There are some oncologic orthopaedic surgeons who combine vascularized fibula grafting with allograft reconstruction in the primary tumor operation.…”

Section: Autograft Bonementioning

confidence: 99%

The Use of Bone Grafts and Bone Graft Substitutes in Pediatric Orthopaedics

Gross

2012

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

Bone graft substitutes have become progressively more widely used, and are currently heavily marketed. To make intelligent decisions, a complete knowledge of autograaft and allograft bone healing is essential, including the definition of "sterile". Differences in donor selection and tissue processing may confound the user not familiar with the implications of these different approaches. Specific products include demineralized bone matrix (DBM), specific growth factors (recombinant BMP's), ceramic grafts, and platelet-rich plasma (PRP). There are a number of useful applications of bone graft substitues for pediatric orthopaedists, but the data base is evolving. This paper describes the current status of these products.

show abstract

Locking Versus Standard Plates for Allograft Fixation After Tumor Resection in Children and Adolescents

Abstract: Results of this investigation suggest that use of locking plates for allograft-host junction fixation is associated with improved union rates and less need for additional operations when compared with standard compression plates.

Cited by 23 publications

References 19 publications

Corrective lower limb osteotomies in children using temporary external fixation and percutaneous locking plates

Corrective lower limb osteotomies in children using temporary external fixation and percutaneous locking plates

Locking Compression Plate in Musculoskeletal Oncology 'a Friend in Need'

The Use of Bone Grafts and Bone Graft Substitutes in Pediatric Orthopaedics

Contact Info

Product

Resources

About