Luis Aponte Tinao

Distal femur osteoarticular allograft reconstruction after grade III open fractures in pediatric patients.

Even though massive osteoarticular allografts have been reported to restore function successfully after tumor resection, little has been published about this procedure in post-traumatic joint reconstruction. We report two pediatric patients who sustained a grade III open fracture of the distal femur and were treated with osteoarticular allografts as a salvage procedure. In each patient, a femoral condyle was inserted to treat the bone and cartilage defect, and a 4.5 dynamic compressive plate was applied to fix the graft to the host bone. There were no complications after the reconstructive procedure. At 2 and 10 years of follow-up, both patients showed a favorable functional and radiographic outcome using the scoring instruments of the Musculo-skeletal Tumor Society and the International Symposium on Limb Salvage.

Resultados clínicos y funcionales en reconstrucciones con aloinjertos intercalares de tibia

Background The purpose of this study was to evaluate the survival, the complications and the functional outcome of intercalary tibial allografts reconstructions following tumor resections. Methods Intercalary tibia segmental allografts were implanted in 26 consecutive patients after segmental resections. Average follow-up was 6 years. Allograft survival was determined with the Kaplan-Meier method. Function was evaluated with the Musculoskeletal Tumor Society scoring system (MSTS). Results The rate of survival was 84% (CI 95%: 90%- 70%) at 5 years and 79% at 10 years (CI 95%: 95%-63%). Allografts were removed in 5 patients (3 due to infections and 2 due to local recurrences). Two patients showed diaphyseal nonunion and 3 had an incomplete fracture, but it was not necessary to remove the allografts. Average MSTS functional score was 29 points (range 27 to 30). Conclusions Despite the incidence of complications, this analysis showed an acceptable survival with excellent functional scores. The use of intercalary allograft clearly has a place in the reconstruction of a segmental defect created by the resection of a tumor in the diaphyseal and/or metaphyseal portion of the tibia.