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Does inter-tibiofibular graft still have a role in the treatment of lower-limb non-union?

Ferraz, L ; Juvet-Segarra, M ; Pocquet, X ; Mertl, P ; Havet, E

Orthopaedics & traumatology, surgery & research, 2016-04, Vol.102 (2), p.223-226 [Periódico revisado por pares]

France: Elsevier Masson SAS

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  • Título:
    Does inter-tibiofibular graft still have a role in the treatment of lower-limb non-union?
  • Autor: Ferraz, L ; Juvet-Segarra, M ; Pocquet, X ; Mertl, P ; Havet, E
  • Assuntos: Adolescent ; Adult ; Aged ; Bone graft ; Bone Transplantation - methods ; External fixator ; External Fixators ; Female ; Fibula - injuries ; Fibula - surgery ; Fracture Fixation ; Fractures, Ununited - surgery ; Humans ; Male ; Middle Aged ; Non-union ; Orthopedics ; Retrospective Studies ; Surgery ; Tibial fracture ; Tibial Fractures - complications ; Tibial Fractures - surgery ; Young Adult
  • É parte de: Orthopaedics & traumatology, surgery & research, 2016-04, Vol.102 (2), p.223-226
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
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  • Descrição: Abstract Introduction Tibial non-union is a complication that poses a real challenge for surgeons. Several forms of treatment, depending on the type of non-union, have been described. The present study sought to assess results for treatment of tibial non-union by inter-tibiofibular graft (ITFG). Material and method An exhaustive cohort study was performed on the files of 33 patients: 25 male, 8 female; mean age, 44 years. Twenty cases involved high-energy trauma. Twenty-four were open fractures. Twenty-two concerned diaphyseal fracture, 10 of which were complex segmental. Eleven concerned distal fracture, including 4 complete articular fractures. There were 17 cases of septic non-union. There were no cases of severe bone defect. ITFG was performed at a mean 8.7 months post-trauma, as first-line treatment in 30 cases and in second line in 3. Results Thirty-one patients showed bone consolidation, at a mean 7.2 months. The 2 failures resulted from technical error. Trauma kinetics emerged as a risk factor for failure. Discussion ITFG remains a useful treatment option in tibial non-union, whether infected or not. The present results are comparable with those of the literature. Although the present series comprised only tight non-union, a study of the literature showed that ITFG can treat bone defects up to 4 or 5 cm. Functional results showed tibiotalar joint stiffening, due more to immobilization and non-weight-bearing than to syndesmosis. ITFG thus remains relevant to the treatment of tibial non-union. Level of evidence IV, retrospective study.
  • Editor: France: Elsevier Masson SAS
  • Idioma: Inglês
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