Page 113 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

Intercalary allografts
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Table A-3. Overview of literature on intercalary allografts. Data Ortiz-Cruz14 Frisoni20
Aponte-Tinao13 (2012)
Muscolo15 (2004)
Reference Donati16 (2000)
Zimel18 (2009)
Cara17 (1994)
Gerrand19 (2003)
Current study (2013)
No. of patients 104 101 Localization
83
59
39
38
23
20
87
Radius Fibula Ulna
3% - - - 3% - - - 3% - - -
- - - - - - - - - - - -
67 (24 - 220) Plates 93%
112 (24 - 238)
61 (24 - 182)
60† (24 - 264)
-‡
84† (14 - 231)
35 (12 - 75)
54 (10 - 134)
Follow-up* Fixation type
Intramedullaray nail
7% - - -
90% 10% -
-
-
65% 19% 16% -
- 33% 16% 52% -
59% 15%
8% 92%
78% 4% -
- 17%
- - - - -
71% 9% 6% - 14%
Screws
- -
Plates and screws
26% -
- -
Intramedullary nail and plate
- 46%
Overall complications Speci c complications
-
-
-
-
-
42%
-
76%
Infection 12% Fracture 17% Nonunion 30%
-
1%
5%
0% 30% 55% 15%
18%
17%
10%
14% 29% 40% 17% -
Failure 14%
24%
18%
15%
39%
12%
10%
Details
More complica- tions with adju- vant therapy, no clear in uence of osteosynthe- sis type.
26% hybrid grafts; age and allograft length ad- versely related to outcome.
More nonunions after intramedul- lary nail xation and in diaphyse- al junctions.
More non- unions in diaphyseal junctions.
29% of femoral and 73% of tibial recon- structions were hybrid grafts.
Allograft-pros- thesis com- parison; total population: 85 patients, 47 en- doprostheses.
Deceased patients excluded.
All reconstruc- tions reinforced with pressur- ized intramed- ullary cement.
(1997) (2012)
Femur 38% 100% 100% 68% Tibia 37% - - 32% Humerus 18% - - -
100% 61% - 35% - - 4%
25% 30% 45%
51% 39%
8%
2%
-
-
84 (25 - 262)
27%
16%
7%
3%
9%
0%
47%
24%
15%
16%
15%
15%
*The values are given as the median, with the range in parentheses, in months. †The values are given as the mean, with the range in parentheses, in months. ‡This value was not reported for intercalary allografts speci cally.
72% 28%