Assessment of fibular regeneration after graft harvesting in patients with benign bone tumors: A retrospective study comparing different age groups.

Autor: Mustafa MAR; Orthopaedic Surgery, Ain Shams University, Faculty of Medicine Cairo, 11566 Cairo, Egypt., El Masry AM; Orthopaedic Surgery, Ain Shams University, Faculty of Medicine Cairo, 11566 Cairo, Egypt. Electronic address: ayman_elmasry@med.asu.edu.eg., Azmy SI; Orthopaedic Surgery, Ain Shams University, Faculty of Medicine Cairo, 11566 Cairo, Egypt., El Mowafi MA; Orthopaedic Surgery, Ain Shams University, Faculty of Medicine Cairo, 11566 Cairo, Egypt.
Jazyk: angličtina
Zdroj: Orthopaedics & traumatology, surgery & research : OTSR [Orthop Traumatol Surg Res] 2022 Jun; Vol. 108 (4), pp. 103108. Date of Electronic Publication: 2021 Oct 08.
DOI: 10.1016/j.otsr.2021.103108
Abstrakt: Introduction: Using non-vascularized fibula as autogenous graft has gained much success in reconstruction after tumor resection owing to its simplicity. Donor-site morbidity related to fibula deficiency includes valgus ankle, chronic pain and stress fractures of the ipsilateral tibia.
Hypothesis: Growth potential before skeletal maturity is the most important factor promoting fibular regeneration after non- vascularized harvesting, and its decline with skeletal maturity causes failure of fibular regeneration.
Patients and Methods: This is a retrospective study of the patients with benign bone tumors who required bone defect reconstruction by non-vascularized fibular graft utilizing a periosteal preserving technique. The study entailed 118 patients below the age of 12, 100 age 12-18, and 80 above the age of 18.
Results: In children below 12, regeneration was complete in 95%, incomplete in 4.2% and partial in 0.8% of the cases. In adolescents, regeneration was complete in 72%, incomplete in 15% and partial in 13% of the cases. After skeletal maturity, no regeneration occurred in 92.5%of the patients, while partial regeneration occurred in 7.5% of the cases. Valgus ankle occurred in 2.8% of the cases before skeletal maturity, and none in older patients.
Discussion: Complete regeneration after non-vascularized fibula graft harvesting is the rule in pediatric patients and to a lesser extent in adolescent group. This is usually associated by near normal regaining of the regenerate strength and function. Non-regeneration dominates in older age group. The length of the harvested segment has no impact on the regeneration or the remodeling process.
Level of Evidence: IV; case series, retrospective comparative study.
(Copyright © 2021 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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