A novel bone graft technique combined with plating for aseptic recalcitrant long bone nonunion.
Autogenous structural iliac bone
Bone graft
Bone-forming channel technique
Locking compression plate
Nonunion
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
20 Sep 2022
20 Sep 2022
Historique:
received:
24
02
2022
accepted:
14
09
2022
entrez:
20
9
2022
pubmed:
21
9
2022
medline:
24
9
2022
Statut:
epublish
Résumé
To evaluate the outcomes and efficacy of a new technique of autogenous iliac crest bone grafting combined with locking compression plate (LCP) vertical fixation for aseptic recalcitrant long bone nonunion. From July 2010 to September 2020, 36 aseptic recalcitrant long bone nonunions were treated with a bone-forming channel technique and internal LCP fixation. All the patients had received one or more failed treatments. The injury mechanism, nonunion type and duration, and prior treatments were recorded pre-operation. The routine treatment process included nonunion area exposure, previous implant removal, sclerotic bone debridement, LCP fixation, bone-forming channel creation, and iliac bone grafting, and a second LCP fixation when required. At follow-up, X-ray images were obtained to assess bone healing and implant failure. Visual analog scale (VAS), fracture site stability, limb function, activity, muscle strength, limb length, and complications were recorded. A total of 34 patients (24 males and 10 females) were finally enrolled, with a mean age of 49.8 ± 12.3 years. At a mean follow-up of 35.6 ± 22.0 months, 32 patients displayed bone union, with a healing rate of 94.1% and mean union time of 6.8 ± 2.4 months. The VAS score was 0.7 ± 1 at the final follow-up. The functional results showed that 19 patients were excellent, 11 patients were good, 2 patients were poor, and 2 patients did not heal. Bone-forming channel technique combined with LCP vertical fixation is an excellent option to treat recalcitrant long bone nonunion. Therapeutic Level IV.
Sections du résumé
BACKGROUND
BACKGROUND
To evaluate the outcomes and efficacy of a new technique of autogenous iliac crest bone grafting combined with locking compression plate (LCP) vertical fixation for aseptic recalcitrant long bone nonunion.
METHODS
METHODS
From July 2010 to September 2020, 36 aseptic recalcitrant long bone nonunions were treated with a bone-forming channel technique and internal LCP fixation. All the patients had received one or more failed treatments. The injury mechanism, nonunion type and duration, and prior treatments were recorded pre-operation. The routine treatment process included nonunion area exposure, previous implant removal, sclerotic bone debridement, LCP fixation, bone-forming channel creation, and iliac bone grafting, and a second LCP fixation when required. At follow-up, X-ray images were obtained to assess bone healing and implant failure. Visual analog scale (VAS), fracture site stability, limb function, activity, muscle strength, limb length, and complications were recorded.
RESULTS
RESULTS
A total of 34 patients (24 males and 10 females) were finally enrolled, with a mean age of 49.8 ± 12.3 years. At a mean follow-up of 35.6 ± 22.0 months, 32 patients displayed bone union, with a healing rate of 94.1% and mean union time of 6.8 ± 2.4 months. The VAS score was 0.7 ± 1 at the final follow-up. The functional results showed that 19 patients were excellent, 11 patients were good, 2 patients were poor, and 2 patients did not heal.
CONCLUSION
CONCLUSIONS
Bone-forming channel technique combined with LCP vertical fixation is an excellent option to treat recalcitrant long bone nonunion.
LEVEL OF EVIDENCE
METHODS
Therapeutic Level IV.
Identifiants
pubmed: 36127646
doi: 10.1186/s12891-022-05830-8
pii: 10.1186/s12891-022-05830-8
pmc: PMC9487050
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
873Subventions
Organisme : Natural Science Foundation of Shaanxi Province
ID : 2020JM-689
Informations de copyright
© 2022. The Author(s).
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