Surgical management of large segmental femoral and radial bone defects in a dog

Abstract

In this case report, we describe the use of a cylindrical titanium mesh cage combined with cancellous bone graft to surgically manage large segmental bone defects in a dog. A seven-year-old, neutered male cross-breed dog, with highly comminuted fractures of the right femur and the left radius and ulna, was referred for treatment. Previous open reduction and internal fixation of these fractures had failed. Following implant removal and debridement of each bone, a 71 mm segmental femoral defect and a 27 mm segmental radial defect were present. A commercially available cylindrical titanium mesh cage was filled with ss-tricalcium phosphate crystals mixed with an equal volume of autogenous cancellous bone graft. The mesh cage was aligned with the proximal and distal parts of each bone using an intramedullary pin passing through the cage, and a locking plate was applied to the proximal and distal fracture fragments to produce compression against the titanium cage. The dog had a successful long-term clinical outcome, and radiographic examination at 22 and 63 weeks after surgery showed the formation of remodelling bridging callus that was continuous across the titanium cage in each of the fractures. Due to the relative simplicity of the technique and the favourable outcome in this case, it should be considered an option when managing comminuted fractures with large bone defects.

Biocompatibility and degradation of the open-pored magnesium scaffolds LAE442 and La2

“…Current porous bone substitutes made of polymers or ceramics, such as β-tricalcium phosphate (TCP), can show good biocompatibility and osseointegration, but have low mechanical stability, so they are mainly used to fill smaller defects or are applied as coatings [12,13]. For effective treatment of long tubular bone defects, cylindrical titanium mesh cages combined with a bone graft have been used to repair critical size bone defects [14,15]. However, removal of the inserted titanium mesh cage is not possible after it has been surrounded by bone.…”

Assessment of the degradation rates and effectiveness of different coated Mg-Zn-Ca alloy scaffolds for in vivo repair of critical-size bone defects

“…Although these treatments have achieved positive outcomes, they are not without drawbacks, indicating the need for improvement] [ 4 , 6 , 7 ]. To effectively repair defects in long bones, Cobos et al [ 8 ] described a simple and effective technique that uses a titanium mesh cage in combination with a bone graft to repair critical-size bone defects [ 9 – 11 ]; however, it is not possible to remove the inert titanium mesh after it becomes covered with bone, and the continual presence of titanium mesh in a bone may cause stress shielding and secondary bone absorption [ 12 ]. Thus, how to pair new materials with known surgical grafting options remains a major clinical problem.…”