Ununited Diaphyseal Forearm Fractures with Segmental Defects: Plate Fixation and Autogenous Cancellous Bone-Grafting

Ring, David; Allende, Christian; Jafarnia, Koroush; Allende, Bartolome T.; Jupiter, Jesse B.

doi:10.2106/00004623-200411000-00013

Cited by 116 publications

(99 citation statements)

References 20 publications

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“…Treating forearm nonunions is a challenge for the orthopaedic surgeon. Reviewing the literature of this subject reveals that despite the use of various techniques for treating forearm nonunions, the results are not completely satisfying and there is still debate regarding which type of technique to use [13,14,19,20].…”

Section: Introductionmentioning

confidence: 99%

Aseptic Forearm Nonunions Treated by Plate and Opposite Fibular Autograft Strut

Faldini

Pagkrati

Nanni

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Forearm nonunion frequently changes the relationship between the radius and ulna and may lead to impairment of forearm function. We propose a new surgical technique for aseptic forearm nonunions combining a fibular cortical autograft strut with a metal plate and a fibular intercalary autograft in cases with a segmental bone defect. We retrospectively reviewed 20 patients with a mean age of 31 years (range, 17-48 years) at the time of surgery. Minimum followup was 12 years (mean, 14 years; range, 12-21 years). There were no intraoperative or postoperative complications. At last followup, all forearm bones had remodeled. The mean visual analog pain scale was 1 (range, 0-3). Forearm function improved; there were no radiographic signs of ankle arthritis at followup. Surgical treatment of aseptic forearm nonunions by combining a massive fibular cortical autograft strut with a plate and associating a fibular intercalary autograft in case of a segmental bone defect led to bone healing, improved forearm function, and a durable outcome with long-term followup.

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Section: Introductionmentioning

confidence: 99%

Aseptic Forearm Nonunions Treated by Plate and Opposite Fibular Autograft Strut

Faldini

Pagkrati

Nanni

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…When treatment involves crushed cancellous bone grafting, according to one case report, success can be achieved when the segmental bone defect is between 20 mm and 80 mm in length 12) . There is also a report indicating that in cases with extensive segmental bone defects of the tibia and soft tissue damage, treatment is possible with free latissimus dorsi muscle grafting and cancellous bone grafting, without requiring the use of a free vascularized fibula graft 13) .…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Infected Long Bone Defects After Limb-Threatening Trauma: Application of Locked Plate and Autogenous Cancellous Bone Graft

Kawakami

Konno

Ejiri

et al. 2015

FJMS

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Background : Treatment strategies for bone defects include free bone grafting, distraction osteogenesis, and vascularized bone grafting. Because bone defect morphology is often irregular, selecting treatment strategies may be difficult. With the Masquelet technique, a fracture site is bridged and fixed with a locking plate after treating deep infection with antibiotic -containing cement, and a free cancellous bone -graft is concomitantly placed into the defects. This procedure avoids excessive bone resection. Methods : We studied 6 patients who underwent surgical treatment for deep infection occurring after extremity trauma (2004 through In all patients, bone defects were filled with antibiotic -containing cement beads after infected site debridement. If bacterial culture of infected sites during curettage was positive, surgery was repeated to refill bone defects with antibiotic -containing cement beads. After confirmation of negative bacterial culture, osteosynthesis was performed, in which bone defects were bridged and fixed with locking plates. Concomitantly, crushed cancellous bone grafts harvested from the autogenous ilium was placed in the bone defects. Results : Time from bone grafting and plate fixation to bone union was at least 3 and at most 6 months, 4 months on average. Infection relapsed in one patient with methicillin -resistant Staphylococcus aureus, necessitating vascularized fibular grafting which achieved bone union. No patients showed implant loosening or breakage or infection relapse after the last surgery during follow -up. Conclusion : The advantage of cancellous bone grafting include applicability to relatively large bone defects, simple surgical procedure, bone graft adjustability to bone defect morphology, rapid bone graft revascularization resulting in high resistance to infection, and excellent osteogenesis.

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“…After 6 months, all patients were healed and none required a follow-up procedure. 19 Autografts also yield good-toexcellent results in 90% of cystic talus lesions. 20 However, several trials have reported mixed outcomes with autologous bone grafting due, in part, to the lack of immediate structural support.…”

Section: Clinical Outcomes Autograftmentioning

confidence: 98%

Perspectives on the clinical utility of allografts for bone regeneration within osseous defects: a narrative review

Miller¹,

Block²

2011

ORR

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A variety of bone grafts and bone graft substitutes is available for treatment of osseous defects although adequate reconstruction of the residual void following fracture, arthroplasty, or tumor/cyst resection remains a therapeutic challenge. This narrative review evaluates the peer-reviewed literature and examines relevant outcomes in patients treated with bone grafts and bone graft substitutes for surgical management of osseous defects. Although autograft, xenograft, and ceramic bone graft substitutes are used for a variety of orthopedic applications, they have distinct limitations in clinical practice. Bone allograft material is a safe and effective adjunct to treatment of osseous defects.

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Ununited Diaphyseal Forearm Fractures with Segmental Defects: Plate Fixation and Autogenous Cancellous Bone-Grafting

Cited by 116 publications

References 20 publications

Aseptic Forearm Nonunions Treated by Plate and Opposite Fibular Autograft Strut

Aseptic Forearm Nonunions Treated by Plate and Opposite Fibular Autograft Strut

Surgical Treatment for Infected Long Bone Defects After Limb-Threatening Trauma: Application of Locked Plate and Autogenous Cancellous Bone Graft

Perspectives on the clinical utility of allografts for bone regeneration within osseous defects: a narrative review

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