[Lyophilized small-segment allogeneic bone in repairing bone defect due to benign bone tumor and tumor-like lesions after resection and curettage].
OBJECTIVE
To investigate the clinical application and complication of the lyophilized small-segment allogeneic bone used in repairing bone defects caused by benign bone tumor and tumor-like lesions after resection and curettage.


METHODS
From December 1999 to December 2005, 230 patients (156 males, 74 females; age, 5-56 years, averaged 32. 8 years), who had bone defects caused by benign bone tumors and tumor-like lesions after surgical resection and curettage, were treated by the lyophilized small-segment allogeneic bones. The cavities left by the tumor curettage ranged in size from 1.0 cm x 0.8 cm to 10.0 cm x 2.0 cm, and the bone defects were about 1.0 to 3.5 cm in diameter after the localized resection of the bones. According to the bone defect degrees, the autogenous nonvascular iliac bone and the bone allograft (0.5-30.0 g) were implanted, followed by the drainage for 2-3 days and the use of antibiotics to prevent infection. The postoperative systemic and local reactions were observed, and the regular X-ray examinations were performed to observe the bone union.


RESULTS
There was no significant difference in the allergic reactions, such as postoperative temperature, drained amount, and body swelling, between this kind of transplantation and the autogenous bone transplantation. The wounds in 196 patients were healed by the first intension. The wounds in 34 patients had extravasate. Among them, the wound was healed by changing dressing in 30 cases; the wound had delayed healing in 4, including 3 whose wounds were healed by changing dressing for 3-4 weeks,and 1 whose wound was healed by taking out the implants. The follow-up for 6-60 months (average, 38 months) revealed that all the patients had the allograft unions of the bones within 6-18 months after the transplantation, and only 6 patients had recurrence of the tumor (3.0%). Evaluated by the Mankin,Komender and WANG Zhiqiang's standards, 196 (85.22%) patients were satisfied with their outcomes while the other 34 (14. 78%) patients were not satisfied.


CONCLUSIONS
The lyophilized small-segment allogeneic bone has a good compatibility and osteogenesis, when it is used in repairing bone defects caused by benign bone tumor and tumor-like lesions after resection and curettage. So, this kind of bone is a good, convenient and safe material for the bone transplantation. The important factors affecting the allograft union are as follows: the mechanical stability in the recipient region, local blood supply, and management of the bone cavity left by resection and curettage of the bone tumor.
Guo
Shibing
S
Department of Orthopedics, Second Affiliated Hospital, Inner Mongolia Medical College, Huhhot Inner Mongolia, China. guoshibing2006@sina.com
Feng
Wei
W
Jia
Yanfei
Y
D000293:Adolescent; D000328:Adult; D001845:Bone Cysts / Q000000981:diagnostic imaging / Q000601:surgery; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003475:Curettage; D005260:Female; D005500:Follow-Up Studies; D005612:Freeze Drying; D006801:Humans; D007085:Ilium / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014945:Wound Healing; D055815:Young Adult