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The indications and donor-site morbidity of tibial cortical strut autografts in the management of defects in long bones.

Abstract Aims The primary aim of this study was to determine the morbidity of a tibial strut autograft and characterize the rate of bony union following its use. Patients and Methods We retrospectively assessed a series of 104 patients from a single centre who were treated with a tibial strut autograft of > 5 cm in length. A total of 30 had a segmental reconstruction with continuity of bone, 27 had a segmental reconstruction without continuity of bone, 29 had an arthrodesis and 18 had a nonunion. Donor-site morbidity was defined as any event that required a modification of the postoperative management. Union was assessed clinically and radiologically at a median of 36 months (IQR, 14 to 74). Results Donor-site morbidity occurred in four patients (4%; 95% confidence interval (CI) 1 to 10). One patient had a stress fracture of the tibia, which healed with a varus deformity, requiring an osteotomy. Two patients required evacuation of a haematoma and one developed anterior compartment syndrome which required fasciotomies. The cumulative probability of union was 90% (95% CI 80 to 96) at five years. The type of reconstruction (p = 0.018), continuity of bone (p = 0.006) and length of tibial graft (p = 0.037) were associated with the time to union. Conclusion The tibial strut autograft has a low risk of morbidity and provides adequate bone stock for treating various defects of long bones. Cite this article: Bone Joint J 2018;100-B:667-74.
PMID
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Authors

Mayor MeshTerms

Bone Transplantation

Transplant Donor Site

Keywords

Autograft

Bone graft

Cortical strut

Morbidity

Reconstruction

Tibia

Tumour

Journal Title the bone & joint journal
Publication Year Start




PMID- 29701102
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  - The indications and donor-site morbidity of tibial cortical strut autografts in
      the management of defects in long bones.
PG  - 667-674
LID - 10.1302/0301-620X.100B5.BJJ-2017-0577.R2 [doi]
AB  - Aims The primary aim of this study was to determine the morbidity of a tibial
      strut autograft and characterize the rate of bony union following its use.
      Patients and Methods We retrospectively assessed a series of 104 patients from a 
      single centre who were treated with a tibial strut autograft of > 5 cm in length.
      A total of 30 had a segmental reconstruction with continuity of bone, 27 had a
      segmental reconstruction without continuity of bone, 29 had an arthrodesis and 18
      had a nonunion. Donor-site morbidity was defined as any event that required a
      modification of the postoperative management. Union was assessed clinically and
      radiologically at a median of 36 months (IQR, 14 to 74). Results Donor-site
      morbidity occurred in four patients (4%; 95% confidence interval (CI) 1 to 10).
      One patient had a stress fracture of the tibia, which healed with a varus
      deformity, requiring an osteotomy. Two patients required evacuation of a
      haematoma and one developed anterior compartment syndrome which required
      fasciotomies. The cumulative probability of union was 90% (95% CI 80 to 96) at
      five years. The type of reconstruction (p = 0.018), continuity of bone (p =
      0.006) and length of tibial graft (p = 0.037) were associated with the time to
      union. Conclusion The tibial strut autograft has a low risk of morbidity and
      provides adequate bone stock for treating various defects of long bones. Cite
      this article: Bone Joint J 2018;100-B:667-74.
FAU - Lauthe, O
AU  - Lauthe O
AD  - Orthopaedic Department, Hopital Cochin, Paris, France.
FAU - Soubeyrand, M
AU  - Soubeyrand M
AD  - Orthopaedic Department, Hopital Bicetre, Paris, France.
FAU - Babinet, A
AU  - Babinet A
AD  - Orthopaedic Department, Hopital Cochin, Paris, France.
FAU - Dumaine, V
AU  - Dumaine V
AD  - Orthopaedic Department, Hopital Cochin, Paris, France.
FAU - Anract, P
AU  - Anract P
AD  - Orthopaedic Department, Hopital Cochin and Universite Paris Descartes and INSERM 
      U1153, Paris, France.
FAU - Biau, D J
AU  - Biau DJ
AD  - Orthopaedic Department, Hopital Cochin and Universite Paris Descartes and INSERM 
      U1153, Paris, France.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Adult
MH  - Autografts
MH  - Bone Diseases/*surgery
MH  - *Bone Transplantation
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Morbidity
MH  - Retrospective Studies
MH  - Surgical Wound/surgery
MH  - Tibia/physiopathology/*transplantation
MH  - *Transplant Donor Site
MH  - Transplantation, Autologous
MH  - Wounds and Injuries/*surgery
MH  - Young Adult
OTO - NOTNLM
OT  - Autograft
OT  - Bone graft
OT  - Cortical strut
OT  - Morbidity
OT  - Reconstruction
OT  - Tibia
OT  - Tumour
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-2017-0577.R2 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 May 1;100-B(5):667-674. doi:
      10.1302/0301-620X.100B5.BJJ-2017-0577.R2.