FRACTURES IN LARGE-SEGMENT ALLOGRAFTS
FRACTURES IN LARGE-SEGMENT ALLOGRAFTS
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DOI：
10.2106/00004623-199311000-00011
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发表时间：
1993-11-01
影响因子：
5.3
通讯作者：
GARRY, D
中科院分区：
文献类型：
--
作者：
THOMPSON, RC;PICKVANCE, EA;GARRY, D
在因肿瘤切除后植入的30例大段同种异体移植物中，有16例在植入后平均26个月时发生骨折，随访时间至少为36个月。13例骨折进行了手术治疗，我们发现在骨折部位缺乏血管化和软组织附着。对于7个断裂的移植物，有与宿主骨愈合的影像学和临床体征。16个骨折的移植物中有8个用一个或多个自体骨移植物挽救，2个自发愈合。因此，35例移植手术中有29例被认为是成功的，因为已经达到了最初的目标--为骨骼置换提供功能节段。多变量分析显示，当移植物的内固定包括穿透移植物皮质的器械时，接受化疗的患者骨折的相关性显著（p < 0.05）。
Sixteen of thirty-rive large-segment allografts that had been implanted after resection for neoplastic conditions, and had been followed for a minimum of thirty-six months, were found to have fractured at a mean of twenty-six months after the implantation. Thirteen of the fractures were treated operatively, and we found a lack of vascularization and soft-tissue attachments to the graft at the fracture site. For seven fractured grafts, there were radiographic and clinical signs of union with the host bone. Eight of the sixteen grafts that had fractured were salvaged with one or more autogenous bone grafts, and two healed spontaneously. Thus, twenty-nine of the thirty-five grafting procedures were considered to have been successful in that the initial objective - provision of a functional segment for skeletal replacement - had been achieved.Multivariate analysis revealed a significant correlation for fracture in patients who were receiving chemotherapy when internal fixation of the graft had included devices that penetrated the cortices of the graft (p < 0.05).