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

• 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
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-017-1990-0

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.