Autologous structural iliac bone grafts in reconstructions of short bone defects in the hand and foot after primary bone tumor resections: a single-institution retrospective study

The use of structural autografts from the iliac crest for reconstruction of bony defects in the hand and foot was described by Wilson and Lance in 1965. However, very few series of this technique are published and long-term results are unknown. We present a single-institution series of 23 patients w...

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Bibliographic Details
Published in:European journal of orthopaedic surgery & traumatology 2017-08, Vol.27 (6), p.797-804
Main Authors: Lesensky, J., Nemec, K., Kofranek, I., Matejovsky, Z.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Arthroplasty - adverse effects
Arthroplasty - methods
Autografts
Bone cancer
Bone Neoplasms - diagnostic imaging
Bone Neoplasms - surgery
Chemotherapy
Cysts
Defects
Female
Foot Diseases - diagnostic imaging
Foot Diseases - surgery
Foot Joints - diagnostic imaging
Foot Joints - surgery
Hand - diagnostic imaging
Hand - surgery
Hand Joints - diagnostic imaging
Hand Joints - surgery
Hand Strength
Humans
Ilium - transplantation
Joint surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Morbidity
Original Article • TUMORS - HAND - FOOT
Patients
Radiation
Radiography
Reconstructive Surgical Procedures - adverse effects
Reconstructive Surgical Procedures - methods
Retrospective Studies
Skin & tissue grafts
Surgical Orthopedics
Traumatic Surgery
Tumors
Walking
X-rays
Young Adult
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Summary:The use of structural autografts from the iliac crest for reconstruction of bony defects in the hand and foot was described by Wilson and Lance in 1965. However, very few series of this technique are published and long-term results are unknown. We present a single-institution series of 23 patients with a mean follow-up of 92 months. We also describe a novel modification of this technique using the anterior superior iliac spine for reconstruction of the adjacent joint. Failure rate was 13% at mean of 17.3 months. All patients had a firm grip in the hand and walked without support. Bony fusion was achieved in all cases regardless of the type of fixation used. The use of ASIS for joint reconstruction was successful, particularly in low-demand joints. We encountered 1 case of instability and progressive stiffness in weight-bearing joints. This is a reliable method of reconstructing bony defects in the hand or foot following tumor resections.
ISSN:1633-8065
1432-1068
DOI:10.1007/s00590-017-1990-0