J Liu1, Z Wang, Y Hu, G Liang, Y Huang. 1. Department of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Abstract
OBJECTIVE: To analyze the postoperative complications of bone and joint allografting for the reconstruction of massive bone defect after the resection of malignant bone tumors and its management. METHODS: Bone-joint allografting for the reconstruction of massive bone defect after the resection of malignant bone tumors with different internal fixations was performed in 106 patients with complete follow-up data. Bone healing time, complication rate, and final results in different allografts were compared. Operation indications, complications and internal fixation were also analyzed. The final results were determined according to the Mankin's standard. RESULTS: Allografts Alcohol immersed were more susceptible to infection, non-union, etc. Allografts and combined prosthesis were superior to semi-articular transplantation. Complications included deep infection (10%), skin necrosis (12.2%), local recurrence (14.4%), and delayed union or non-union (15.6%). Dynamic interlocked intramedullary nailing was superior to conventional intramedullar nailing and compression plates. CONCLUSIONS: Allografting is acceptable for the reconstruction of massive bone defect after tumor resection. Its results are encouraging after proper management of complications caused by surgical technique, internal fixation and soft tissue repair.
OBJECTIVE: To analyze the postoperative complications of bone and joint allografting for the reconstruction of massive bone defect after the resection of malignant bone tumors and its management. METHODS: Bone-joint allografting for the reconstruction of massive bone defect after the resection of malignant bone tumors with different internal fixations was performed in 106 patients with complete follow-up data. Bone healing time, complication rate, and final results in different allografts were compared. Operation indications, complications and internal fixation were also analyzed. The final results were determined according to the Mankin's standard. RESULTS: Allografts Alcohol immersed were more susceptible to infection, non-union, etc. Allografts and combined prosthesis were superior to semi-articular transplantation. Complications included deep infection (10%), skin necrosis (12.2%), local recurrence (14.4%), and delayed union or non-union (15.6%). Dynamic interlocked intramedullary nailing was superior to conventional intramedullar nailing and compression plates. CONCLUSIONS: Allografting is acceptable for the reconstruction of massive bone defect after tumor resection. Its results are encouraging after proper management of complications caused by surgical technique, internal fixation and soft tissue repair.