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2022, Number 1

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Ortho-tips 2022; 18 (1)

Use of orthobiologics and allograft in the treatment of pseudoarthrosis with femoral diaphyseal bone loss

Lobato SMB, Sánchez AR, Barriga MMA, Silva MJA, Gutiérrez-Mendoza I, Rodríguez BÁ, Matus JJ, García BM, Cugat BR

Language: Spanish
References: 24
Page: 80-85
PDF size: 266.84 Kb.


ABSTRACT

Pseudoarthrosis is a complication that poses a challenge for the orthopedist. If is associated with bone loss, a salvage surgery is indicated. There is no protocol for treatment for pseudoarthrosis with a "critical defect". The induced membrane technique, distraction osteogenesis, among others, has been described; however, the long time and elevated costs involved have opened a new landscape on the research of new protocols. The "diamond concept" which is not only based of improving biomechanics, but also introduces biological stimulation as a pillar of treatment, was recently introduced. We present the case of a 16-year-old female patient with a femoral shaft fracture after a traffic accident, treated initially with a centromedullar blocked nailing that progresses to pseudoarthrosis, presenting a 5 cm bone loss. Treatment consisted of removing the centromedullar blocked nail, resection of the nonviable bone segment, osteosynthesis with another centromedullar blocked nailing, placement a 7 cm diaphyseal allograft, platelet-rich plasma (PRP), matrix allograft, and bone chips, thus achieving radiographic and clinical consolidation; restoring limb function in a shorter time, considering the PRP as the main orthobiological element in this case.


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