Relevance of deep decortication and vascularization in a case of post-traumatic femoral non-union treated with grafts, platelet gel and bone marrow stromal cells.
Knee Surg Sports Traumatol Arthrosc
; 20(9): 1834-8, 2012 Sep.
Article
em En
| MEDLINE
| ID: mdl-22113222
ABSTRACT
PURPOSE:
A male patient suffering from non-union of the femoral diaphysis after a traumatic fracture was treated with deep decortication and grafted with lyophilized bone, platelet gel (PG) and autologous bone marrow stromal cells (BMSCs). After 40 days from surgery, he was re-operated, due to fracture secondary displacement, caused by inappropriate load during sports activity. In addition to radiographs, two bone biopsies were retrieved this allowed for a histological evaluation of the early response of host bone to the graft. To our knowledge, there is no report describing such early tissue response.METHODS:
A clinical-radiographic evaluation of the patient and a histomorphometric analysis of the bone biopsies were performed.RESULTS:
An early reparative bone formation was observed adjacent to the osteointegrated graft. Non-resorbed bone chips and large islands of non-vital bone particles, surrounded by fibrous tissue, were observed in a zone of sclerotic diaphyseal bone, that is the process was delayed despite decortication.CONCLUSIONS:
These findings support the concept, until now evidenced only by imaging, that bone chips added with PG and BMSCs are effective in shortening the healing time in fracture non-union. The clinical relevance of deep decortication and vascularization is emphasized. LEVEL OF EVIDENCE Therapeutic studies-investigating the results of treatment, Level V.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fraturas do Fêmur
/
Fraturas não Consolidadas
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Itália