[Preliminary results of 79 massive bone allografts in the conservative treatment of malignant tumors in adults and children].
We have used massive allografts, preserved by freezing to -30 degrees C and sterilised by irradiation, to reconstruct large defects in bone after resection of high grade neoplasms. The average length of the defect was 20.5 cm. Complications included 3 deep infections, 8 pseudoarthroses, of which 4 joined after further operation and 3 are still under treatment, and 4 late fractures of the graft. Seventy two cases have been followed up, and the functional result was excellent in 30, very good in 22, good in 13, poor in 3 and bad in 4. In 3 cases H.L.A. antibodies against the graft have been detected, but no clinical or radiological abnormality was noted. Bone scintigraphy showed progressive revascularisation of the graft from surrounding muscle. Reattachment of muscles to the allografts was successful, and contributed to the good functional results. Reconstruction with sterilised allografts, in association with long stemmed titanium prostheses or a cemented nail, gave a better functional results than using massive stainless steel prostheses in patients with a reasonable life expectancy.
Delépine
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Unité d'Orthopédie, Clinique du pré Gentil, Rosny-Sous-Bois, France.
Delépine
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N
D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology; D001858:Bone Nails; D001859:Bone Neoplasms / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D005269:Femur / Q000637:transplantation*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000209:etiology / Q000503:physiopathology; D006622:Hip Prosthesis; D006801:Humans; D006811:Humerus / Q000637:transplantation*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D019736:Prostheses and Implants; D011542:Pseudarthrosis / Q000209:etiology* / Q000503:physiopathology; D012086:Reoperation; D013977:Tibia / Q000637:transplantation*; D014025:Titanium; D014184:Transplantation, Homologous
D014025:Titanium
Résultats préliminaires de 79 allogreffes osseuses massives dans le traitement conservateur des tumeurs malignes de l'adulte et de l'enfant.