Revista de la Asociación Argentina de Ortopedia y Traumatología
versión On-line ISSN 1852-7434
PESCIALLO, César et al. Bone allograft: femoral and tibial shaft non union. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2010, vol.75, n.3, pp. 275-281. ISSN 1852-7434.
Background: Five to 10% of fractures do not heal after treatment. It is important to restore mechanical stability and biological conditions. The main purpose of this study is to analyze the treatment outcomes of femoral and tibial shaft non union, using bone allograft and intramedullary nailing. Methods: Twenty-five patients with atrophic shaft nonunion were treated on our institution from January 2000 to December 2008, using bone allograft and intramedullary nailing. Cancellous bone graft was used in 22 cases and structural graft in 2. The mean follow up was 37 months. One patient was lost to follow up. The average age was 41. We evaluated a total of 12 (50%) patients with femoral and 12 (50%) with tibial non union. Twenty two (92%) were atrophic and 2 (8%) floating. Results: Twenty-two patients achieved union (91.6%). The average time was 4.75 months for femoral pseudoarthrosis (4-7 m) and 4.2 months when the tibia was affected (3-8 m). In the cases where structural graft was used, healing time was 8 months on average. Consolidation was defined by radiographic and fluoroscopic tests, stability and quality of the callus were evaluated. Two patients are still being treated because the bone has not healed (8.3%). Conclusions: Bone allograft is an important tool when treating shaft non unions. We observed a consolidation rate of 91.6% at 4 months using bone allograft with a stable osteosynthesis. The benefits of bone allograft are: improved biological environment, reduced operative morbidity and surgical time.
Palabras clave : Non union; Bone allograft; Nailing treatment.