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Management of extra-articular segmental defects in long bone using a titanium mesh cage as an adjunct to other methods of fixation.

Abstract Aims This study reviews the use of a titanium mesh cage (TMC) as an adjunct to intramedullary nail or plate reconstruction of an extra-articular segmental long bone defect. Patients and Methods A total of 17 patients (aged 17 to 61 years) treated for a segmental long bone defect by nail or plate fixation and an adjunctive TMC were included. The bone defects treated were in the tibia (nine), femur (six), radius (one), and humerus (one). The mean length of the segmental bone defect was 8.4 cm (2.2 to 13); the mean length of the titanium mesh cage was 8.3 cm (2.6 to 13). The clinical and radiological records of the patients were analyzed retrospectively. Results The mean time to follow-up was 55 months (12 to 126). Overall, 16 (94%) of the patients achieved radiological filling of their bony defect and united to the native bone ends proximally and distally, resulting in a functioning limb. Complications included device failure in two patients (12%), infection in two (12%), and wound dehiscence in one (6%). Four patients (24%) required secondary surgery, four (24%) had a residual limb-length discrepancy, and one (6%) had a residual angular limb deformity. Conclusion A titanium mesh cage is a useful adjunct in the treatment of an extra-articular segmental defect in a long bone. Cite this article: Bone Joint J 2018;100-B:646-51.
PMID
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Authors

Mayor MeshTerms

Prostheses and Implants

Keywords

Mesh cage

Segmental bone loss

Trauma

Journal Title the bone & joint journal
Publication Year Start




PMID- 29701099
OWN - NLM
STAT- MEDLINE
DCOM- 20180516
LR  - 20180516
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 5
DP  - 2018 May 1
TI  - Management of extra-articular segmental defects in long bone using a titanium
      mesh cage as an adjunct to other methods of fixation.
PG  - 646-651
LID - 10.1302/0301-620X.100B5.BJJ-2017-0817.R2 [doi]
AB  - Aims This study reviews the use of a titanium mesh cage (TMC) as an adjunct to
      intramedullary nail or plate reconstruction of an extra-articular segmental long 
      bone defect. Patients and Methods A total of 17 patients (aged 17 to 61 years)
      treated for a segmental long bone defect by nail or plate fixation and an
      adjunctive TMC were included. The bone defects treated were in the tibia (nine), 
      femur (six), radius (one), and humerus (one). The mean length of the segmental
      bone defect was 8.4 cm (2.2 to 13); the mean length of the titanium mesh cage was
      8.3 cm (2.6 to 13). The clinical and radiological records of the patients were
      analyzed retrospectively. Results The mean time to follow-up was 55 months (12 to
      126). Overall, 16 (94%) of the patients achieved radiological filling of their
      bony defect and united to the native bone ends proximally and distally, resulting
      in a functioning limb. Complications included device failure in two patients
      (12%), infection in two (12%), and wound dehiscence in one (6%). Four patients
      (24%) required secondary surgery, four (24%) had a residual limb-length
      discrepancy, and one (6%) had a residual angular limb deformity. Conclusion A
      titanium mesh cage is a useful adjunct in the treatment of an extra-articular
      segmental defect in a long bone. Cite this article: Bone Joint J
      2018;100-B:646-51.
FAU - Attias, N
AU  - Attias N
AD  - St. Joseph's Hospital, 350 W Thomas Rd, Phoenix, Arizona 85013, USA.
FAU - Thabet, A M
AU  - Thabet AM
AD  - Department of Orthopaedic Surgery and Rehabilitation, Paul L. Foster School of
      Medicine,Texas Tech Health Sciences Center, 4801 Alberta Avenue, El Paso, Texas
      79905, USA.
FAU - Prabhakar, G
AU  - Prabhakar G
AD  - Paul L. Foster School of Medicine at Texas Tech Health Sciences Center, 4801
      Alberta Avenue, El Paso, Texas 79905, USA.
FAU - Dollahite, J A
AU  - Dollahite JA
AD  - Department of Orthopaedic Surgery, University of New Mexico, Albuquerque, New
      Mexico 87131, USA.
FAU - Gehlert, R J
AU  - Gehlert RJ
AD  - Department of Orthopaedic Surgery, University of New Mexico, Albuquerque, New
      Mexico 87131, USA.
FAU - DeCoster, T A
AU  - DeCoster TA
AD  - Department of Orthopaedic Surgery, University of New Mexico, Albuquerque, New
      Mexico 87131, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
RN  - 0 (Biocompatible Materials)
RN  - D1JT611TNE (Titanium)
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Biocompatible Materials
MH  - Female
MH  - Femur/surgery
MH  - Fracture Fixation, Internal/*instrumentation
MH  - Fractures, Bone/*surgery
MH  - Humans
MH  - Humerus/surgery
MH  - Male
MH  - Middle Aged
MH  - *Prostheses and Implants
MH  - Radius/surgery
MH  - Tibia/surgery
MH  - Titanium
MH  - Wounds and Injuries/*surgery
MH  - Young Adult
OTO - NOTNLM
OT  - Mesh cage
OT  - Segmental bone loss
OT  - Trauma
EDAT- 2018/04/28 06:00
MHDA- 2018/05/17 06:00
CRDT- 2018/04/28 06:00
PHST- 2018/04/28 06:00 [entrez]
PHST- 2018/04/28 06:00 [pubmed]
PHST- 2018/05/17 06:00 [medline]
AID - 10.1302/0301-620X.100B5.BJJ-2017-0817.R2 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 May 1;100-B(5):646-651. doi:
      10.1302/0301-620X.100B5.BJJ-2017-0817.R2.