HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Manfrini, M. Articles by Mercuri, M. Search for Related Content PubMed PubMed Citation Articles by Manfrini, M. Articles by Mercuri, M. Social Bookmarking                      What's this?

Imaging of Vascularized Fibula Autograft Placed Inside a Massive Allograft in Reconstruction of Lower Limb Bone Tumors

¹ Dipartimento di Oncologia Muscolo-Scheletrica, Istituto Ortopedico Rizzoli, Via Pupilli 1, Bologna 40136, Italy.
² Present address: Institut Gustave Roussy, Rue Camille Desmoulins, Villejuif 94800, France.
³ Centro Traumatologico Ortopedico, Via Largo Palagi 1, Firenze 50139, Italy.

OBJECTIVE. Bone allografts and vascularized fibula autografts were combined (the fibula inside the massive allograft) for skeletal reconstruction in a homogeneous group of patients. To verify the biologic behavior of the grafts, we followed the series using conventional radiography and CT analysis.

MATERIALS AND METHODS. Twenty-four patients with bone tumors had intercalary segments of tibia or femur reconstructed and were followed up for 36–120 months. Sequential radiographs and CT scans were analyzed.

RESULTS. Three types of behavior were observed. In 13 patients, the allograft maintained its architecture without fracture, although a regular enlargement of the inlaid fibula led to progressive integration with the allograft. A dense line on allograft endosteum was the first sign of bone bridges heralding fusion of the two grafts. In eight patients, fracture or nonunion of the allograft occurred, and the autograft reacted with rapid appearance of dense hypertrophy that again induced bridges to the allograft. In three patients, no changes in autograft size and density were followed by fracture with no callus formation. This behavior was interpreted as unsuccessful vascularization of the autograft.

CONCLUSION. Sequential radiography and CT analysis enabled us to understand the changes in a combined graft offering an original way to revascularize bone allografts.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M. Ghert, N. Colterjohn, and M. Manfrini The Use of Free Vascularized Fibular Grafts in Skeletal Reconstruction for Bone Tumors in Children J. Am. Acad. Ortho. Surg., October 1, 2007; 15(10): 577 - 587. [Abstract] [Full Text] [PDF]

				C. Delloye, O. Cornu, V. Druez, and O. Barbier Bone allografts: WHAT THEY CAN OFFER AND WHAT THEY CANNOT J Bone Joint Surg Br, May 1, 2007; 89-B(5): 574 - 580. [Abstract] [Full Text] [PDF]

				C. R. Krestan, H. Noske, V. Vasilevska, M. Weber, G. Schueller, H. Imhof, and C. Czerny MDCT versus digital radiography in the evaluation of bone healing in orthopedic patients. Am. J. Roentgenol., June 1, 2006; 186(6): 1754 - 1760. [Abstract] [Full Text] [PDF]