Le tibia proximal avec un clou en place peut être un site donneur pour un prélèvement d’os spongieux - 28/11/21
Proximal tibia with an inserted nail can be an available donor site for harvesting cancellous bone
Abstract |
Introduction |
A preexisting implant at the harvesting site might dissuade the surgeon from considering the site as available for bone harvesting. This study aimed to investigate the quantity of cancellous bone graft that can be harvested from a proximal tibia with an inserted nail and to report the clinical outcomes of this bone graft harvesting technique.
Hypothesis |
Our hypothesis was that a certain amount of cancellous bone graft could be harvested from a proximal tibia with an inserted nail without compromising the surrounding environment and outcome of nonunion treatment.
Material and methods |
Bone grafting from an ipsilateral proximal tibia with an inserted nail was performed in 32 patients for treating defect nonunion. The amount of harvested bone was measured using three parameters (weight, height, and volume). The effects of the proximal locking screw position on the quantity and location of bone graft harvest were analyzed. Clinical outcomes were evaluated by assessing the radiologic healing of the bone graft site and by assessing the donor-site complications.
Results |
The mean bone defect volume in the nonunion site was 31.1±18.3 (range, 10.6–87.0) cm3. The mean quantity of harvested bone from proximal tibias with an inserted nail was 21.2g, height was 3.9cm, and volume was 26.3cm3. A positive correlation was found between the quantity of harvested bone and the level of the lateral oblique interlocking screw hole in the tibial nail. All grafted bone successfully consolidated in all cases at an average of 5.8 months postoperatively. However, joint penetration during bone harvesting occurred in one case.
Discussion |
The bony defect, which measured about 14.3cm3 could be filled with cancellous bone from a PT with an existing IM nail, without additional bone graft requirements. Even if an intramedullary nail exists inside the proximal tibia, harvesting cancellous bone at this site can be a viable option without serious complications.
Level of evidence |
IV; retrospective descriptive study.
Le texte complet de cet article est disponible en PDF.Keywords : Proximal tibia, Bone harvesting, Bone grafting, Quantity, Nail
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 107 - N° 8
P. 1067 - décembre 2021 Retour au numéro
Article précédent
- Les pseudarthroses infectées du tibia: évaluation de la méthode d’Ilizarov avec compression distraction sans geste de débridement local
- Mohammed Anter Meselhy, Mahmoud Kandeel, Abd Sameh Halawa, Mohamed Salah Siger
- Influence de l’âge sur la consolidation osseuse après un allongement des membres par une méthode intramédullaire
- Lukas Zak, Richard Arnhold, Thomas M. Tiefenboeck, Gerald E. Wozasek
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?