scholarly journals Structural Bicortical Autologous Iliac Crest Bone Graft Combined with the Tunnel Bone Tamping Method for the Depressed Tibial Plateau Fractures

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Zhongzheng Wang ◽  
Yanbin Zhu ◽  
Xiangtian Deng ◽  
Xin Xing ◽  
Siyu Tian ◽  
...  
Keyword(s):  
Bone Graft ◽  
Tibial Plateau ◽  
Iliac Crest ◽  
Short Form ◽  
Tibial Plateau Fractures ◽  
Absolute Difference ◽  
Iliac Crest Bone Graft ◽  
Special Surgery ◽  
The Mean

Background. Clinically, autologous iliac crest bone grafts (ICBG) and bone tamping methods are often applied to manage depressed tibial plateau fractures (DTPFs). The purpose of this study was to describe and evaluate the technique of using structural bicortical autologous ICBG combined with the tunnel bone tamping method (TBTM) for treating DTPFs. Methods. All patients with DTPFs who underwent structural bicortical autologous ICBG combined with TBTM from January 2016 to February 2018 were prospectively analysed. Demographics, injury, surgery, postoperative complications, and clinical outcomes were recorded. All patients were followed up for more than 30 months. Postoperative radiography and CT were employed to assess fracture healing and the reduction quality. Results. Forty-three of the included patients completed the follow-up. No malreduction was observed. Based on the immediate postoperative imaging, the intra-articular step-off was significantly reduced (8.19 mm preoperatively vs. 1.30 mm immediate postoperatively, P < 0.001 ). From the immediate operation to the latest follow-up, the reduction was maintained significantly well, with a nonnegligible absolute difference (0.18 mm, P = 0.108 ). A remarkable secondary loss of reduction (intra-articular step   off > 3   mm ) was found in two elderly patients (2/43, 4.65%). The incidence of complications related to the bone-graft donor and bone-graft site was 2.33% and 4.65%, respectively. At the final follow-up, the mean Hospital for Special Surgery (HSS) score of the knee was 98.19 ± 2.89 , and the mean 36-Item Short-Form Health Survey (SF-36) score was 95.65 ± 4.59 . Conclusion. Structural bicortical autologous ICBG combined with TBTM is radiologically effective and stable in terms of complications for the DTPFs.

scholarly journals Composite Xenohybrid Bovine Bone-Derived Scaffold as Bone Substitute for the Treatment of Tibial Plateau Fractures

2019 ◽  
Vol 9 (13) ◽  
pp. 2675 ◽  
Author(s):  
Riccardo Ferracini ◽  
Alessandro Bistolfi ◽  
Riccardo Garibaldi ◽  
Vanessa Furfaro ◽  
Agnese Battista ◽  
...  
Keyword(s):  
Bone Graft ◽  
Tibial Plateau ◽  
Short Form ◽  
Bone Substitutes ◽  
Tibial Plateau Fractures ◽  
Bovine Bone ◽  
Lateral Projection ◽  
Autologous Iliac Bone Graft ◽  
Ikdc 2000

Introduction: Tibial plateau fractures represent a common challenge for orthopaedic surgeons, sometimes representing complex cases to manage, where augmentation using bone grafts is required for stabilisation. Autologous iliac bone graft (AIBG) is the current gold standard for bone grafting. In order to overcome limitations related to the procedure, alternative strategies, like allogenic and xenogeneic bone substitutes have been investigated. Here, within the framework of an observational clinical study, we report clinical and radiological outcomes of patients treated for tibial plateau fractures with a composite xenohybrid bone graft, aiming at assessing clinical and radiological outcomes. Materials and Methods: We performed a cohort retrospective study of patients treated for tibial plateau fractures from May 2017 to January 2018. Thirty-four patients, i.e. 100% of those having received the bone graft under investigation for tibial plateaux fracture treatment, met the inclusion criteria and were enrolled in the study. Patients were assessed at 2 weeks, and then at a 1-, 3-, and 6-months, and 1-year follow-up. At each evaluation patients filled a visual analogue scale (VAS) for the level of pain during the day life activities and underwent physical exam and anteroposterior and lateral projection radiographs of the knee. At 1 year the Tegner Lysholm Scoring Scale, International Knee Document Committee 2000 (IKDC 2000), and Short Form (36) Health Survey (SF-36) were administered. Results: At 1-year, mean VAS decreased from 6.33 ± 1.40 to 1 ± 0.79 (P < 0.0001); Tegner Lysholm Scoring Scale was 89 ± 4.10 and mean IKDC 2000 was 78.67 ± 3.31. No infections, neurovascular complications or adverse effects related to implants were reported during the clinical exams at follow-up. Mean ROM was 124 ± 6°. Radiographs did not show defects of consolidation or progressive post-surgical subsidence and demonstrated a good grade of integration of the implant. Conclusions: Clinical and radiological outcomes, and scores of questionnaires, were good. The xenograft has demonstrated to be a safe biomaterial, with satisfactory mechanical and biological performances in the mid-term period. It also showed a high grade of osteointegration and remodelling.

scholarly journals Lumbar and para-iliac hernias: an alternative technique

2021 ◽  
Vol 48 ◽  
Author(s):  
MARIA PESSOLE BIONDO SIMÕES ◽  
ALEXANDRE CONTIN MANSUR ◽  
SILVANIA KLUG PIMENTEL
Keyword(s):  
Bone Graft ◽  
Blunt Trauma ◽  
Iliac Crest ◽  
Aortic Surgery ◽  
Iliac Bone ◽  
Lumbar Region ◽  
Alternative Technique ◽  
Iliac Bone Graft ◽  
The Mean

ABSTRACT Lumbar and para-iliac hernias are rare and occur after removal of an iliac bone graft, nephrectomies, retroperitoneal aortic surgery, or after blunt trauma to the abdomen. The incidence of hernia after the removal of these grafts ranges from 0.5 to 10%. These hernias are a problem that surgeons will face, since bone grafts from the iliac crest are being used more routinely. The goal of this article was to report the technique to correct these complex hernias, using the technique of fixing the propylene mesh to the iliac bone and the result of this approach. In the period of 5 years, 165 patients were treated at the complex hernia service, 10 (6%) with hernia in the supra-iliac and lumbar region, managed with the technique of fixing the mesh to the iliac bone with correction of the failure. During the mean follow-up of 33 months (minimum of 2 and maximum of 48 months), there was no recurrence of the hernias.

scholarly journals Minimally invasive subtalar arthrodesis for traumatic subtalar arthritis

2019 ◽  
Vol 47 (12) ◽  
pp. 6129-6138 ◽  
Author(s):  
Lei Sun ◽  
Zhigang Kong ◽  
Ming Xu
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Bone Graft ◽  
Iliac Crest ◽  
Operation Time ◽  
Iliac Crest Bone Graft ◽  
Intraoperative Blood Loss ◽  
Subtalar Arthrodesis ◽  
Subtalar Arthritis ◽  
The Mean

Objective This study was performed to introduce a new method of minimally invasive subtalar arthrodesis (MISA) and assess its clinical effects on traumatic subtalar arthritis (TSA). Methods Fifteen patients (8 male and 7 female; age range, 36–56 years; mean age, 48.67 years) with TSA who underwent MISA were included. All patients were treated using a series instrument. The intraoperative and postoperative indexes were recorded. Results Among all patients, the mean operation time was 59.67 ± 16.31 minutes and the mean intraoperative blood loss was 43.33 ± 52.87 mL. Four patients underwent iliac crest bone graft surgery, and one patient developed a complication involving fat liquefaction of the iliac crest wound. The mean bony fusion time among all patients was 3.5 months. According to the American Orthopaedic Foot and Ankle Society standard, an excellent outcome was obtained in eight patients and a good outcome was obtained in seven patients. The operation time and intraoperative blood loss were significantly different between patients who did and did not undergo iliac crest bone graft surgery. Conclusion MISA is a simple and effective method for the treatment of TSA.

scholarly journals Comparison of Functional Outcomes of Tibial Plateau Fractures Treated with Nonlocking and Locking Plate Fixations: A Nonrandomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammad Ali Tahririan ◽  
Seyyed Hamid Mousavitadi ◽  
Mohsen Derakhshan
Keyword(s):  
Functional Outcomes ◽  
Tibial Plateau ◽  
Locking Plate ◽  
Plate Fixation ◽  
Tibial Plateau Fractures ◽  
Plate Method ◽  
Plate Group ◽  
Plateau Fracture ◽  
The Mean

Fixation of tibial plateau fractures with plate has been widely used. This prospective study was planned to compare locking plate fixation of tibial plateau fracture with nonlocking methods in terms of their functional outcomes. The subjects of the study were selected from consecutive patients suffering from tibial plateau fractures referred to Kashani Hospital in Isfahan, Iran, between 2012 and 2013 and were candidate for surgery. The final included patients were assigned to two groups, those who were treated with locking plate (n=20) and those who were treated with nonlocking plates (N=21). The mean duration of follow-up was 13.4 months (ranging between 10 and 17 months). The mean of knee scores was significantly higher in locking plate group than in nonlocking plate group at the follow-up time (80.20±10.21 versus 72.52±14.75, P=0.039). Also, the mean VAS pain severity score was significantly lower in locking plate group compared with nonlocking plate group (4.45±2.50 versus 6.00±2.59, P=0.046). This study confirmed superiority of the locking plate method over nonlocking plate method with regard to knee score as well as VAS pain score.

Wrist Arthrodesis Using an Embedded Iliac Crest Bone Graft

1993 ◽  
Vol 18 (5) ◽  
pp. 595-600 ◽  
Author(s):  
E. LENOBLE ◽  
H. OVADIA ◽  
D. GOUTALLIER
Keyword(s):  
Bone Graft ◽  
Grip Strength ◽  
Iliac Crest ◽  
Delayed Union ◽  
Iliac Crest Bone Graft ◽  
Iliac Crest Graft ◽  
Wrist Arthrodesis ◽  
Carpometacarpal Joints ◽  
Dorsal Branch

34 patients treated by the iliac crest bone graft technique for wrist arthrodesis were reviewed. The average age was 45.6 years and the mean follow-up was 45 months. The procedure is performed through a straight ulnar approach and the head of the ulna is removed. A longitudinal trench is created in both distal radius and carpus preserving the anterior, posterior and lateral cortices. A curved trapezoidal monocortical iliac crest bone graft is embedded inside the trench. The position of the arthrodesis automatically follows the curvature of the graft. No fixation device is used. A short-arm cast is applied for 2 to 3 months. All arthrodeses except two fused within 3 months. Pain was completely relieved in 85% of the cases. Pronation and supination returned to normal 5 months post-operatively. Grip strength was increased in 80% of the cases. The carpometacarpal joints remained pain-free even when not fused. Complications were rare: two lesions of the dorsal branch of the ulnar nerve; two cases of delayed union due to errors in technique, and displacement of the graft in one case. Although it is technically demanding, the embedded iliac crest graft wrist arthrodesis improves pronation and supination as a result of resection of the distal radio-ulnar joint, preserves or improves grip strength, and relieves pain.

Primary Fusion as Salvage following Talar Neck Fracture: A Case Report

2003 ◽  
Vol 24 (4) ◽  
pp. 368-371 ◽  
Author(s):  
Rhys H. Thomas ◽  
Timothy R. Daniels
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Bone Graft ◽  
Range Of Motion ◽  
Avascular Necrosis ◽  
Iliac Crest ◽  
Iliac Crest Bone Graft ◽  
Type Iv ◽  
Neck Fracture

For a 29-year-old man with a three-week-old Hawkins Type IV talar neck fracture, intra-operative reduction and fixation were not possible due to soft tissue contractures and severe comminution. A primary talonavicular and subtalar arthrodesis with the use of iliac crest bone graft was performed. Postoperative follow-up at 16 months demonstrated solid fusions, no avascular necrosis of the talus and a functional range of motion at the ankle. He was not capable of returning to his job of roof maintenance.

scholarly journals Outcomes and complications of the reamer irrigator aspirator versus traditional iliac crest bone graft harvesting: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Francesco Oliva ◽  
Filippo Migliorini ◽  
Francesco Cuozzo ◽  
Ernesto Torsiello ◽  
Frank Hildebrand ◽  
...  
Keyword(s):  
Bone Graft ◽  
Iliac Crest ◽  
Meta Analysis ◽  
Medullary Canal ◽  
Current Evidence ◽  
Iliac Crest Bone Graft ◽  
Bone Graft Harvesting ◽  
Mean Time ◽  
Lower Site

Abstract Background The reamer irrigator aspirator (RIA) is a relatively recent device that is placed in the medullary canal of long bones to harvest a large volume of bone marrow, which is collected in a filtered canister. This study compares outcomes and complications of the RIA versus a traditional iliac crest bone graft (ICBG) for the treatment of bone defects. Methods This meta-analysis was conducted according to the PRISMA guidelines. The Embase, Google Scholar, PubMed, and Scopus databases were accessed in June 2021. All clinical trials comparing the RIA and ICBG with a minimum of 6 months follow-up were included. Results Data from 4819 patients were collected. The RIA group demonstrated lower site pain (P < 0.0001), fewer infections (P = 0.001), and a lower rate of adverse events (P < 0.0001). The ICBG group demonstrated a greater rate of bone union (P < 0.0001). There was no difference between groups in VAS (P = 0.09) and mean time to union (P = 0.06). Conclusion The current evidence supports the use of the RIA, given its low morbidity and short learning curve.

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