Your browser doesn't support javascript.
loading
Induced membrane technique using enriched bone grafts for treatment of posttraumatic segmental long bone defects.
Piacentini, F; Ceglia, M J; Bettini, L; Bianco, S; Buzzi, R; Campanacci, D A.
Afiliação
  • Piacentini F; Department of Traumatology and General Orthopedics, Azienda Ospedaliera Universitaria Careggi, Florence, Italy. fedepiace@live.it.
  • Ceglia MJ; Department of Traumatology and General Orthopedics, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
  • Bettini L; Department of Traumatology and General Orthopedics, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
  • Bianco S; Department of Traumatology and General Orthopedics, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
  • Buzzi R; Department of Traumatology and General Orthopedics, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
  • Campanacci DA; Department of Traumatology and General Orthopedics, Azienda Ospedaliera Universitaria Careggi, Florence, Italy.
J Orthop Traumatol ; 20(1): 13, 2019 03 11.
Article em En | MEDLINE | ID: mdl-30859333
ABSTRACT

BACKGROUND:

Reconstruction of posttraumatic bone defects represents a difficult challenge. The induced membrane technique is an effective two-stage procedure for bone defect reconstruction. To overcome the problems of autologous bone grafting, different graft substitutes have been investigated. The aim of the present study is to evaluate our clinical experience in reconstruction of critical posttraumatic bone defects using an induced membrane technique based on a combination of autologous graft and allograft (cancellous bone) enriched with platelet-rich plasma (PRP) and bone marrow concentrate aspirate (BMCA). MATERIALS AND

METHODS:

Between 2009 and 2014, we reconstructed 18 posttraumatic bone defects in 16 patients. Their average length was 6.4 cm (range 1.6-13.2 cm). The defect location was the femur in nine cases (50%), the tibia in eight (44%) cases, and the humerus in one (6%) case. In all cases, we used a combination of autologous and cancellous allograft graft enriched with PRP and BMCA. Bone fixation was achieved using intramedullary nailing in 2 cases (11%), plating in 15 cases (66%), and external fixation in 1 case (6%).

RESULTS:

Both clinical and radiographic union were achieved in 13 (72%) cases (13 patients). Five (28%) cases (four patients) developed nonunion. Nonunion was observed in two of eight (25%) tibial defects and in three (33%) of nine femoral defects (ns). Three of 4 (75%) double defects had delayed union, whereas 2 of 14 (14%) single defects did not heal (p = 0.016). The average length of the 13 defects that united was 6 cm (range 1.6-11.8 cm), while the length of the 5 defects that did not unite was 10.3 cm (range 6-13.2 cm) (p = 0.009).

CONCLUSIONS:

In this series using an induced membrane technique based on a combination of autograft and allograft enriched with BMCA and PRP, the healing rate was lower than in other series where autologous bone graft alone was employed. Nonunion was more frequent in longer and double defects. Further research aimed at developing effective alternative options to autogenous cancellous bone graft is desirable. LEVEL OF EVIDENCE III.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tíbia / Cicatrização / Transplante Ósseo / Procedimentos de Cirurgia Plástica / Plasma Rico em Plaquetas / Fêmur / Fixação Interna de Fraturas Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Tíbia / Cicatrização / Transplante Ósseo / Procedimentos de Cirurgia Plástica / Plasma Rico em Plaquetas / Fêmur / Fixação Interna de Fraturas Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article