The effect of internal fixation on the healing of large allografts.
One hundred and twenty patients had an allograft reconstruction of the femur, tibia, or humerus. Of a total of 183 allograft-host junctions, eight-three were fixed with a plate; ninety-eight, with an intramedullary rod; and two, with screws alone. There was no significant difference between the rate of union after fixation with a plate and that after intramedullary fixation (p = 1.00). However, fixation with a plate was associated with a higher rate of fracture of the allograft (p < 0.0001). Some problem related to the internal fixation of the allograft was identified at eighteen of the twenty junctions that did not heal. There was a significant association (p < 0.001) between a problem in the achievement of stable fixation and the development of a non-union at the allograft-host junction.
Vander Griend
R A
RA
Department of Orthopaedics, University of Florida, Gainesville 32610.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000601:surgery; D001178:Arthroplasty; D001858:Bone Nails; D001859:Bone Neoplasms / Q000601:surgery; D001860:Bone Plates; D001861:Bone Regeneration; D001863:Bone Screws; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D005269:Femur / Q000601:surgery; D017102:Fracture Healing / Q000502:physiology; D005598:Fractures, Spontaneous / Q000209:etiology; D006801:Humans; D006811:Humerus / Q000601:surgery; D016268:Internal Fixators / Q000009:adverse effects; D007719:Knee Joint / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012785:Shoulder Joint / Q000601:surgery; D013977:Tibia / Q000601:surgery; D014184:Transplantation, Homologous / Q000379:methods; D017211:Treatment Failure; D016474:Weight-Bearing; D014945:Wound Healing