Massive intercalary bone allografts in the treatment of primary and secondary bone tumors. A report on 21 cases.
From 1981 to 1993, 21 patients received intercalary bone allografts for reconstruction of the extremity after en bloc tumor resection (15 malignant and 6 benign tumors). The allografts were collected from multiorgan donors and cryopreserved at -70 degrees C. The mean follow-up was 4.4 (range 1-13) years. The fate of the grafts was followed by conventional radiography, bone scintigraphy, and functional assessment. The overall survival rate of the 7 patients with high-grade malignancies was 86%. Solid union of the graft-host sites in less that 15 months occurred in 85%. An increased isotope uptake of the graft indicates that incorporation at the osteotomies as well as remodelling is still continuing at 9 years after operation. The overall complication rate was 43%; 3 patients had two or more complications. Complications were related to the allograft in 6 (infection or fatigue fracture in 1 and delayed healing in 4 cases) and to the osteosynthesis in 3 patients. The definitive results after treatment of complications show that satisfactory results have been obtained in all but 2 patients: 62% had excellent, 19% good, and 10% fair results. Intercalary allografts therefore provide a valuable solution for large skeletal defects after resection of bone tumors.
Voggenreiter
G
G
Abteilung für Unfallchirurgie, Universitätsklinikum Essen, Germany.
Klaes
W
W
Assenmacher
S
S
Schmit-Neuerburg
K P
KP
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000556:secondary / Q000601:surgery*; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy