Cristiani-Winer M, Allende-Nores C, Paganini F, Gutiérrez N

Language: Spanish
References: 7
Page: 223-229
PDF size: 369.63 Kb.

ABSTRACT

Introduction: successful treatment in patients with significant bone defects secondary to infection, non-union and osteoporotic fractures resulting from previous trauma is challenging. In the current literature we did not find any reports that compare the use of intramedullary allograft boards versus the same ones placed lateral to the lesion. Material and methods: we worked on a sample of 20 rabbits (2 groups of 10 rabbits each). Group 1 underwent surgery using the extramedullary allograft placement technique, while group 2 with the intramedullary technique. Four months after surgery, imaging and histology studies were performed to compare between groups. Results: the analysis of the imaging studies showed a statistically significant difference between both groups with greater resorption and bone integration of the intramedullary placed allograft. Regarding histology, there were no statistically significant differences, but there was a significant prediction with a p value < 0.10 in favor of the intramedullary allograft. Conclusion: through our work we were able to show the great difference between the allograft placement technique with respect to imaging and histological analysis using revascularization markers. Although the intramedullary placed allograft shows us greater bone integration, the extramedullary graft will provide more support and structure in patients who require it.

REFERENCES

1. Faldini C, Traina F, Perna F, et al. Surgical treatment of aseptic forearm nonunion with plate and opposite bone graft strut. Autograft or allograft? Inte Orthop. 2015; 39(7): 1343-9.

2. Kanakeshwar RB, Jayaramaraju D, Agraharam D, Rajasekaran S. Management of resistant distal femur non-unions with allograft strut and autografts combined with osteosynthesis in a series of 22 patients. Injury. 2017; 48(Suppl 2): S14-7.

3. Hsiao C, Tsai Y, Yen C, et al. Intramedullary cortical bone strut improves the cyclic stability of osteoporotic proximal humeral fractures. BMC Musculoskelet Disord. 2017; 18(1): 64.

4. Basci O, Karakasli A, Kumtepe E, Güran O, Hav?tc?oglu H. Combination of anatomical locking plate and retrograde intramedullary nail in distal femoral fractures: comparison of mechanical stability. Eklem Hastalik Cerrahisi. 2015; 26(1): 21-6.

5. Lazaro LE, Birnbaum JF, Farshad-Amacker NA, Helfet DL, Potter HG, Lorich DG. Endosteal biologic augmentation for surgical fixation of displaced femoral neck fractures. J Orthop Trauma. 2016; 30(2): 81-8.

6. Yadav, Surender Singh MS(Ortho), FAMS, DLitta,1 The use of a free fibular strut as a "biological intramedullary nail" for the treatment of complex nonunion of long bones. JB JS Open Access. 2018; 3(2): e0050.

7. Schliemann B, Wahnert D, Theisen C, et al. How to enhance the stability of locking plate fixation of proximal humerus fractures? An overview of current biomechanical and clinical data. Injury. 2015; 46(7): 1207-14.

EVIDENCE LEVEL

II