[Articular reconstructions by a costochondral grafting (or osteochondral costal grafting)]
| Autor: | Yves, Tropet, Daniel, Lepage, David, Gallinet, Laurent, Obert, Patrick, Garbuio, Philippe, Vichard |
|---|---|
| Přispěvatelé: | Intervention, innovation, imagerie, ingénierie en santé - UFC (I4S), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Chirurgie Orthopédique Traumatologique et Plastique [Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Centre d'Investigation Clinique de Besançon (Inserm CIC 1431), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]) |
| Jazyk: | francouzština |
| Rok vydání: | 2006 |
| Předmět: |
Cartilage
Articular Male Wrist Joint musculoskeletal diseases Time Factors MESH: Wrist Joint Ribs [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery Transplantation Autologous MESH: Osteotomy Chondrocytes MESH: Aged 80 and over MESH: Osteoarthritis MESH: Bone Transplantation MESH: Chondrocytes Osteoarthritis Humans Aged MESH: Treatment Outcome Aged 80 and over MESH: Aged Bone Transplantation MESH: Middle Aged MESH: Humans MESH: Time Factors MESH: Hyaline Cartilage MESH: Follow-Up Studies Middle Aged MESH: Ribs MESH: Transplantation Autologous MESH: Male Osteotomy Hyaline Cartilage Treatment Outcome Thumb MESH: Cartilage Articular Female MESH: Female Follow-Up Studies MESH: Thumb |
| Zdroj: | Bulletin de l'Académie Nationale de Médecine Bulletin de l'Académie Nationale de Médecine, Elsevier Masson, 2006, 190 (7), pp.1439-56; discussion 1456-7, 1475-7 |
| ISSN: | 0001-4079 |
| Popis: | International audience; We describe a novel technique of costochondral autografting for the treatment of trapeziometacarpal arthritis, radioscaphoid osteoarthritis, malunion of the distal end of the radius, and osteoarticular loss of the MP joints of long fingers. The costal graft harvest technique is always the same. A 5-cm horizontal incision is made over the 9th rib, and the rib is exposed at the osteocartilaginous junction. Cartilaginous grafts are harvested with a scalpel, and osteocartilaginous grafts with a saw. Since 1992, 116 patients with trapezio-metacarpal arthritis have been treated by partial trapeziectomy and autologous rib cartilage grafting. One hundred patients were reviewed with an average follow-up of 5.6 years. The results were better than those of trapeziectomy with tendon interposition or ligamentous reconstruction, owing to good stability of the thumb ray height. For the treatment of radioscaphoid osteoarthritis following scaphoid non union or chronic scapholunate instability, partial carpal arthrodesis and resection of the first row are the classical techniques. As an alternative to these procedures, 18 patients were treated by resection of the proximal portion of the scaphoid and insertion of an osteochondral costal autograft. Mean follow-up is 4.1 years. The results are excellent or good in 15 cases, fair in 2 cases, and poor in 1 case (luxation of the graft). Four patients with articular malunion of the distal radius received an osteocartilaginous costal graft to reconstruct the articular surface of the radius while avoiding partial or total arthrodesis of the wrist. Four patients with segmental osteoarticular loss of the longfingers were treated with the same technique, thereby avoiding silicone arthroplasty. We review the literature on cartilaginous rib grafts in maxillofajcial and orthopaedic surgery. In our experience, MRI and biopsy show viable cartilage but also histologic changes such as revascularization, fibrous transformation and bone metaplasia. |
| Databáze: | OpenAIRE |
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