Treatment of a large segmental bone defect with allograft and autogenous bone marrow graft.
Management of segmental bone defects is a challenge to orthopedic surgeons. We report a 23-year-old man who sustained segmental bone loss of 9 cm in length in his left femur due to an open fracture. Open reduction and internal fixation with a 95 degrees angle blade plate and screws, supplemented with a composite of two femoral head allografts and a graft of 100 mL of autogenous bone marrow, was performed 3 weeks after the injury, when the soft tissues had healed. The postoperative rehabilitation program included delayed weight bearing (crutches for 3 months), a limited early range of motion of the left knee, and quadriceps muscle exercise. Callus bridging was noted on x-ray films 3 months postoperatively. Clinical and radiographic union were noted 6 months after the surgery. We suggest that this new and simple method can be applied to successfully treat segmental bone loss of more than 6 cm in length.
Jean
J L
JL
Department of Orthopedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan ROC.
Wang
S J
SJ
Au
M K
MK
D000328:Adult; D016026:Bone Marrow Transplantation; D016025:Bone Transplantation; D005264:Femoral Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D014182:Transplantation, Autologous