Intercalary allograft reconstruction offers a joint-sparing reconstructive option, but nonunion is a devastating complication. In this article, we want to share our experience of proper dynamization of interlocking in...Intercalary allograft reconstruction offers a joint-sparing reconstructive option, but nonunion is a devastating complication. In this article, we want to share our experience of proper dynamization of interlocking intramedullary nail for nonunion after proximal femoral intercalary allograft reconstruction. In this report, a 19-year-old girl was diagnosed proximal femoral fibroblast osteosarcoma （Enneking lib）. After neoadjuvant chemotherapy, she underwent proximal femoral intercalary allograft reconstruction fixed by retrograde interlocking intramedullary nail. At her follow-up point of one year postoperatively, nonunion was observed in the proximal host-allograft junction. Therefore she underwent the second surgery of dynamization of the interlocking intramedullary nail. After 12 months＇ partial and full weight bearing exercise, bone union occurred. Our early observations show that dynamization of interlocking intramedullary nail can still be a useful means to treat nonunion of host- allograft junction if the local condition of the host and allograft bone are good enough.展开更多
[Abstract] Objective： To evaluate the clinical and radiological outcome of anterior vascularized bone graft in the treatment of primitive nonunion of the scaphoid. Methods： This is a retrospective study of 26 scaph...[Abstract] Objective： To evaluate the clinical and radiological outcome of anterior vascularized bone graft in the treatment of primitive nonunion of the scaphoid. Methods： This is a retrospective study of 26 scaphoid nonunion cases treated by this technique between 2004 and 2009. The mean age was 38 years. Nonunion was of types IIA and IIB according to the Alnot＇s classification and only one case showed a proximal pole necrosis （type IV）. The fixation was ensured by K-wire. The mean immobilization period was 9 weeks. Results： At mean 19 months follow-up, the bone union rate was 88.5%. Failure was noted in three cases. No significant complications secondary to this technique were observed. The mobility in extension and flexion had an average recovery of 18°. Nineteen patients （73%） were free of pain, and the others had occasional pain Conclusions： It is a meticulous surgical technique that provides better union rates than those of conventional scaphoid graft. This technique is first adopted in cases of failure of conventional grafts in the treatment of scaphoid nonunion but the encouraging results suggest expanding indications to primitive nonunion.展开更多
文摘Intercalary allograft reconstruction offers a joint-sparing reconstructive option, but nonunion is a devastating complication. In this article, we want to share our experience of proper dynamization of interlocking intramedullary nail for nonunion after proximal femoral intercalary allograft reconstruction. In this report, a 19-year-old girl was diagnosed proximal femoral fibroblast osteosarcoma （Enneking lib）. After neoadjuvant chemotherapy, she underwent proximal femoral intercalary allograft reconstruction fixed by retrograde interlocking intramedullary nail. At her follow-up point of one year postoperatively, nonunion was observed in the proximal host-allograft junction. Therefore she underwent the second surgery of dynamization of the interlocking intramedullary nail. After 12 months＇ partial and full weight bearing exercise, bone union occurred. Our early observations show that dynamization of interlocking intramedullary nail can still be a useful means to treat nonunion of host- allograft junction if the local condition of the host and allograft bone are good enough.
文摘[Abstract] Objective： To evaluate the clinical and radiological outcome of anterior vascularized bone graft in the treatment of primitive nonunion of the scaphoid. Methods： This is a retrospective study of 26 scaphoid nonunion cases treated by this technique between 2004 and 2009. The mean age was 38 years. Nonunion was of types IIA and IIB according to the Alnot＇s classification and only one case showed a proximal pole necrosis （type IV）. The fixation was ensured by K-wire. The mean immobilization period was 9 weeks. Results： At mean 19 months follow-up, the bone union rate was 88.5%. Failure was noted in three cases. No significant complications secondary to this technique were observed. The mobility in extension and flexion had an average recovery of 18°. Nineteen patients （73%） were free of pain, and the others had occasional pain Conclusions： It is a meticulous surgical technique that provides better union rates than those of conventional scaphoid graft. This technique is first adopted in cases of failure of conventional grafts in the treatment of scaphoid nonunion but the encouraging results suggest expanding indications to primitive nonunion.
