Vascularized Bone Grafts for Upper Limb Reconstruction: Defects at the Distal Radius, Wrist, and Hand

Malizos, Konstantinos N.; Dailiana, Zoe; Innocenti, Marco; Mathoulin, C.; Mattar, Rames; Sauerbier, Michael

doi:10.1016/j.jhsa.2010.08.006

Cited by 55 publications

(40 citation statements)

References 97 publications

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“…[3][4][5] Various non-vascularized and vascularized cortico-spongious bone grafts are employed to treat SN. [6][7][8] Recently, vascularized bone grafts, such as the 1,2-intercompartmental supraretinacular artery pedicled vascularized bone graft (1,2-ICSRA-VBG), 9 the free femoral condyle, [10][11][12] and the free iliac crest bone graft 13 have become increasingly popular in the treatment of SN. Here, treatment principles include surgical angiogenesis due to optimized graft perfusion and stability due to safe internal fixation.…”

Section: Introductionmentioning

confidence: 99%

Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

Hirche

Xiong

Heffinger

et al. 2017

J Orthop Surg (Hong Kong)

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Introduction: Conventional non-vascularized bone grafts as well as vascularized bone grafts are used to treat scaphoid non-union (SN). Due to limited available studies, the field of application using both grafts for SN still remains controversial. The aim of this study was to evaluate a treatment algorithm for the use of both vascularized versus non-vascularized bone grafts based on clinical outcomes and quality of life (QoL) to improve the level of evidence. Materials and Methods: Based on a retrospective cohort study, including 28 patients with vascularized and 45 patients with conventional bone grafts, functional parameters, radiological outcome, Mayo-wrist-score, and QoL by SF-36 were applied to statistically compare the outcome of these two techniques. Results: Time between last procedure or trauma and study group scaphoid reconstruction was almost double in the vascularized bone grafting group. Comparable union rates were achieved with vascularized as well as non-vascularized bone grafts. Significant differences were observed between both groups for grip strength and radial-ulnar active range of motion. Further functional outcomes, radiological outcomes as well as QoL were found similar for both techniques in patients with surgical union. Discussion and conclusions: In order to achieve comparable and appropriate treatment results, vascularized bone grafts are recommended for patients with delayed treatment, impaired scaphoid vascularity, and revision surgery. Even in preselected, complex cases, the results are comparable to conventional grafts, which are the basis for further patient education and approve the powerful role of surgical angiogenesis of vascularized bone grafts.

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Section: Introductionmentioning

confidence: 99%

Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

Hirche

Xiong

Heffinger

et al. 2017

J Orthop Surg (Hong Kong)

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“…3 To avoid such necrosis, vascularized autografts have been transferred instead with good results, 3,23 though their use has been limited to traumatic injuries.…”

Section: Discussionmentioning

confidence: 99%

Digital Joint Reconstruction with Osteotendinous Joint Allograft: Experimental Study in Rats

Iglesias

Cruz-Reyes

Butrón

et al. 2017

Plastic and Reconstructive Surgery - Global Open

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Background:Fresh or frozen nonvascularized osteotendinous joint allografts (OTJA) have not been used previously, clinically or experimentally, for metacarpophalangeal joint reconstruction. Therefore, we evaluated the viability of OTJA for metatarsophalangeal joint (MTJ) reconstruction in rats.Methods:In the experimental group of 12 Lewis rats, we reconstructed the MTJ of the third digit of the hindlimb with a fresh, nonvascularized OTJA obtained from the same digit from 12 donor rats. In the control group of 6 Lewis rats, an autologous composite osteotendinous graft of the MTJ of the same digit was obtained and repositioned in situ as an auto-transplant. Weight, pain, edema, dehiscence, and wound infection were evaluated every 24 hours for 30 days postoperatively. At the end of 30 days, we evaluated digit position, flexion and extension, passive mobility, radiological bone healing, and histological grades of rejection.Results:We found no statistically different changes in weight, edema, pain, digit position, or radiological bone healing in either group. No wound dehiscence or infection was seen in any of the rats. Ten degrees of flexion and extension mobility were lost in the control group; the experimental group lost up to 30 degrees (P = 0.009). Histologically, 9 of the experimental group rats (9/12, 75%) showed rejection reactions compared with none of the controls (0%) (P = 0.009).Conclusions:Fresh nonvascularized OTJA caused an immune reaction without exposure of the graft, but with bone resorption. However, the rats maintained digital form and alignment with decreased passive flexion and extension of 10–30 degrees.

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“…Vascularized bone grafts enhance the vascular supply to facilitate union. [15][16][17][18] We previously reported a series of 13 patients with pseudarthrosis of the scaphoid, who underwent dorsal radius vascularized bone grafting, 10 of whom had an avascular proximal pole. With a minimum follow-up of 1 year, 10 of 13 patients achieved union.…”

Section: Discussionmentioning

confidence: 99%

Supplemental Graft Fixation for Distal Radius Vascularized Bone Graft

Venouziou

Sotereanos

2012

The Journal of Hand Surgery

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Vascularized Bone Grafts for Upper Limb Reconstruction: Defects at the Distal Radius, Wrist, and Hand

Cited by 55 publications

References 97 publications

Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

Vascularized versus non-vascularized bone grafts in the treatment of scaphoid non-union

Digital Joint Reconstruction with Osteotendinous Joint Allograft: Experimental Study in Rats

Supplemental Graft Fixation for Distal Radius Vascularized Bone Graft

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