Nonvascularized Autogenous Bone Graft for Extensive Phalangeal Bone Loss: Case Report

Barron, O. Alton; Sohal, Jennifer Kaur R.; McCulloch, Kenneth; Chia, Benjamin

doi:10.1016/j.jhsa.2008.04.025

Cited by 6 publications

(2 citation statements)

References 8 publications

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“…1 As a result, large segmental bone deficiencies in the proximal or medial phalanges have been repaired with vascularized iliac crest graft, fingers, medial femoral condyle, or nonvascularized iliac crest graft. [2][3][4][5][6][7] Nonetheless, in certain circumstances, a non-vascularized corticocancellous graft may be helpful. As previously stated, the olecranon graft is simple to get and can be entirely integrated into the injury.…”

Section: Introductionmentioning

confidence: 99%

Experience in a public hospital with the use of cortical bone grafts of olecranon for the treatment of bone gaps in the hand

2022

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Background: Bone grafting has been a popular approach for the reconstruction of hand bone abnormalities caused by trauma or tumor removal. Cortical bone grafts have mostly osteoinductive capabilities. Olecranon grafts are reported to be safe because of their low donor morbidity and appropriate quick mechanical stability.Methods: This was a longitudinal descriptive study where 23 patients with hand fractures who were reconstructed with olecranon bone graft were evaluated. We included patients who were admitted to surgery at the “General Dr. Rubén Lenero” Hospital between January 2019 and November 2021. After surgery, a control radiograph of the graft insertion location and the donor area was taken postoperatively.Results: A post-surgery control elbow X-ray did not show any fracture data in all patients. The olecranon graft widths of the 23 patients ranged from 5 mm to 12 mm, with an average width of 7.9 mm. The lengths of the olecranon grafts ranged from 5 mm to 47 mm, with an average length of 19.62 mm.Conclusions: In this study, we found that cortical olecranon grafts have been a safe and viable reconstructive choice for our center for bone gap reconstruction in hand.

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Section: Introductionmentioning

confidence: 99%

Experience in a public hospital with the use of cortical bone grafts of olecranon for the treatment of bone gaps in the hand

2022

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“…arge segmental bone defects of the proximal or middle phalanges reportedly have been treated with free vascularized grafts from the hand, 1 foot, 2 or medial femoral condyle, 3 or with nonvascularized grafts from the iliac crest. [4][5][6] A nonvascularized structural corticocancellous graft from a local site would be advantageous. The olecranon has been used as a source of cancellous graft 7 and recently was reported as a source of corticocancellous graft for the treatment of scaphoid nonunion.…”

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Thumb Proximal Phalanx Reconstruction With Nonvascularized Corticocancellous Olecranon Bone Graft

Soong¹

2015

Orthopedics

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Large segmental bone defects of the phalanges reportedly have been treated with free vascularized grafts from the hand, foot, or knee, or with nonvascularized grafts from the iliac crest. A nonvascularized structural corticocancellous graft from a local site would be advantageous. The olecranon has been used as a source of both cancellous and corticocancellous graft. The authors describe a unique case of the use of nonvascularized corticocancellous olecranon bone graft for structural purposes in a mutilating thumb injury. The patient injured the left thumb with a miter saw, resulting in a large degloving wound over a severely comminuted fracture of the proximal phalanx, with segmental bone loss between a base fragment and displaced condylar fragments. Provisional pin fixation was performed at the time of initial emergent irrigation and debridement, along with repairs of the extensor pollicis longus, radial digital nerve, and dorsal digital nerve. This was followed 3 weeks later by non-vascularized corticocancellous bone grafting from the olecranon to the proximal phalanx under regional anesthesia. The thumb was mobilized at 11 weeks, and solid union was radiographically confirmed at 6 months. The patient achieved moderate active range of motion and was able to return to work as a physical therapist. The elbow healed uneventfully and without pain or fracture at the donor site. This case shows that robust structural bone graft for the phalanges may be obtained from the nearby olecranon, under regional anesthesia, without microsurgery, and with potential advantages over the iliac crest.

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New reconstruction for bone integration of non-vascularized autogenous bone graft with better bony union and revascularisation

Dolderer

Geis

Mueller-Wille

et al. 2017

Arch Orthop Trauma Surg

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This case series suggests that a key-in-slot technique allows non-vascularized bone graft to be used in complex large phalangeal bone defects. Due to better bone contact, a sufficient perfusion and revascularisation of the non-vascularized bone graft can be achieved for a quicker and stable bony union. This method appears to be an alternative to amputation in selected cases with a satisfactory soft-tissue envelope.

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Nonvascularized Autogenous Bone Graft for Extensive Phalangeal Bone Loss: Case Report

Cited by 6 publications

References 8 publications

Experience in a public hospital with the use of cortical bone grafts of olecranon for the treatment of bone gaps in the hand

Experience in a public hospital with the use of cortical bone grafts of olecranon for the treatment of bone gaps in the hand

Thumb Proximal Phalanx Reconstruction With Nonvascularized Corticocancellous Olecranon Bone Graft

New reconstruction for bone integration of non-vascularized autogenous bone graft with better bony union and revascularisation

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