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Abstract
Purpose
This study was aimed to evaluate the result of inlay cortical strut bone grafts for large cysts or cavitary bone lesions in long bones
Materials and Methods
Seven patients with large cyst or cavitary bony lesions were managed with curettage, allogeneic inlay cortical strut and cancellous bone grafts. Additional plate and screw fixations were performed in 6 patients. There were three SBCs, two FDs with secondary ABC changes, one FD and one post-cement spacer removal state. Three of them had pathologic fractures. Progression of bone healing and mechanical support and functional result were evaluated. The mean follow-up period was 25.4 months.
Results
Incorporations into host bones were progressed in all, average 4.2 months in six metaphyseal regions and 5.8 months in five diaphyseal regions respectively. Full structural supports were achieved in all except one patient without any additional procedures. No allograft-related complication was developed. Mean functional score according to the MSTS criteria was 29.6 at last follow up.
References
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Figure 1.
(A) An allogeneic ulna strut cortical bone and cancellous chip bone grafts. (B) After thorough curettage of bony lesion, inlay cortical strut and cancellous chip bones were grafted into the cavitary lesion and the plate and screw fixation was performed, in which the screws purchased the inlay cortical graft provided additional mechanical stability.
Figure 2.
(A) The lateral radiograph of 39 year old man revealed large cystic bony lesion in the proximal ulna with accompanied pathologic avulsion fracture of the olecranon. (B) In six month after operation, bone incorporation had occurred even at diaphyseal junction. (C) Post hardware-removal-radiograph demonstrated complete healing.
Figure 3.
(A) The 5 month postoperative radiograph of right humerus of 58 year old man revealed breakage of plate near the host-allograft bone junction with host bone fracture. (B) Complate incorporation and healing was obtained after a revisional plate fixation and autogenous iliac cancellous bone graft.
Figure 4.
(A) Both hip anteroposterior radiograph of 12 year old girl showed cystic bony lesion with pathologic fracture at right femur neck. (B) A 28 month follow-up scanogram revealed 14 mm leg length discrepancy due to early closure of growth plate at right proximal femur.
Table 1.
Summary of the Cases
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