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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 10/2017

01-10-2017 | Handsurgery

New reconstruction for bone integration of non-vascularized autogenous bone graft with better bony union and revascularisation

Authors: J. H. Dolderer, S. Geis, R. Mueller-Wille, J. L. Kelly, O. Lotter, A. Ateschrang, L. Prantl, D. Schiltz

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2017

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Abstract

Introduction

Phalangeal defects are often seen after tumor resection, infections, and in complex open hand fractures. In many cases, reconstruction is difficult and amputation is performed to avoid prolonged rehabilitation that is often associated with a poor outcome. In these cases, the maintenance of length and function presents a reconstructive challenge.

Methods

We reviewed 11 patients who underwent extensive phalangeal reconstruction with non-vascularized bone graft from the iliac crest using a key-in-slot-joint technique to provide acceptable function and bony union.

Results

In each case, non-vascularized bone graft with a length of 1.4–6.0 cm was used to reconstruct the phalanx. Follow-up ranged from 6 weeks to 5 months, and in all cases, there was bony union after 6 weeks. We evaluated range of motion, function, and as well pain and grip strength of the fingers.

Conclusions

This case series suggests that a key-in-slot technique allows non-vascularized bone graft to be used in complex large phalangeal bone defects. Due to better bone contact, a sufficient perfusion and revascularisation of the non-vascularized bone graft can be achieved for a quicker and stable bony union. This method appears to be an alternative to amputation in selected cases with a satisfactory soft-tissue envelope.
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Metadata
Title
New reconstruction for bone integration of non-vascularized autogenous bone graft with better bony union and revascularisation
Authors
J. H. Dolderer
S. Geis
R. Mueller-Wille
J. L. Kelly
O. Lotter
A. Ateschrang
L. Prantl
D. Schiltz
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 10/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-017-2775-y

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