Vascularized bone grafting in orthopedic surgery:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia [u.a.]
Saunders
2007
|
| Series: | Orthopedic clinics of North America
38,1 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | X, 126 S. zahlr. Ill. |
| ISBN: | 1416043470 9781416043478 |
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| adam_text | VASCULARIZED BONE GRAFTING IN ORTHOPEDIC SURGERY
CONTENTS
Preface
Alexander Y. Shin and Steven L. Moran ix
Free Vascularized Fibular Grafting—25 Years Experience: Tips, Techniques,
and Pearls 1
Michael B. Wood
Thirty years after its introduction vascularized fibula transfer remains an important tool
for all surgeons dealing with particularly challenging bone reconstruction problems. It
should be a consideration when simpler approaches either have failed or are expected
to fail. It is particularly indicated for the reconstruction of massive bone defects asso¬
ciated with sepsis and bony non unions associated with radionecrosis. The successful ex¬
ecution of vascularized fibular grafting, however, requires microvascular expertise and
adherence to sound orthopedic principles for bone healing, including stable internal fixa¬
tion, maximal bone to bone coaptation, and appropriate postoperative management re¬
garding joint mobilization and weight bearing.
Avascular Necrosis of the Femoral Head: Role of Vascularized Bone Grafts 13
J. Mack Aldridge and James R. Urbaniak
This article presents the history and development of as well as the results from the var¬
ious techniques of vascularized bone grafting for the treatment of osteonecrosis (ON) of
the femoral head. The authors have treated more than 2600 patients who had femoral
head ON, using a vascularized fibular graft by way of an intraosseous approach. The
results from this vast experience are summarized and certain pearls and pitfalls regard¬
ing the treatment of femoral head ON using the free vascularized fibular graft are high¬
lighted.
Long Bone Reconstruction with Vascularized Bone Grafts 23
William C. Pederson and David W. Person
The vascularized fibula may be used for long bone reconstruction reliably and success¬
fully Since its description by Taylor, the fibula flap has evolved to solve a myriad of long
bone reconstructive dilemmas. The flap is used routinely for non unions, postoncologic
resections, and congenital defects. It provides faster and more reliable union than non
vascularized grafts. When constructed in a double barrel configuration, it otters the abil¬
ity to bear weight The vascularized fibula can be used to maintain growth by virtue ot
transferring the physis. The vascularized fibula is thus both the workhorse and thor¬
oughbred in long bone reconstruction.
VOLUME 38 • NUMBER 1 • JANUARY 2007 v
Role of Vascularized Bone Grafts in Lower Extremity Osteomyelitis 37
Yuan Kun Tu and Cheng Yo Yen
Vascularized bone grafting seems to be a valuable reconstructive technique for the treat¬
ment of osteomyelitis with skeletal defects greater than 6 cm in length. Fibular osteocu
taneous, composite rib, and iliac osteocutaneous flaps are the most commonly used
vascularized bone grafts clinically. Vascularized bone can obliterate dead space, bridge
large bone defects, enhance bone healing, resist infection by ensuring blood supply, al¬
low early rehabilitation, and ensure better clinical outcomes in the treatment of lower ex¬
tremity osteomyelitis. Success rates range from 80% to 95%. Complications of surgery
include anastomosis failure, donor site problems, and fracture of the grafted bone.
A New Reconstructive Technique for Intercalary Defects of Long Bones:
The Association of Massive Allograft with Vascularized Fibular Autograft.
Long Term Results and Comparison with Alternative Techniques 51
Rodolfo Capanna, Domenico A. Campanacci, Nicolas Belot, Giovanni Beltrami,
Marco Manfrini, Marco Innocenti, and Massimo Ceruso
In 1988, the excellent results obtained with the use of vascularized fibular autograft as a
salvage procedure in massive allograft failures caused by non union or massive resorp
tion prompted a trial of an original reconstructive technique for intercalary defects based
on the primary combination of the two types of graft. The authors believe the excellent
final results and the ability to avoid further salvage surgical procedures justify the pri¬
mary application of this more complicated technique despite longer surgical times.
The Role of Vascularized Bone Grafts in Spine Surgery 61
Alexander Y. Shin and Mark B. Dekutoski
The use of vascularized bone grafts in complex spine reconstruction is particularly at¬
tractive in situations that involve large segmental bone defects, failed previous attempts
at arthrodesis, poor soft tissue beds secondary to infection or radiation exposure necrosis
or failed arthrodesis in neuromuscular disease processes. This article details the indica¬
tions and rational for vascularized bone grafting as well as the results of vascularized
bone grafting of the spine.
Vascularized Bone Grafting for the Treatment of Carpal Pathology 73
Steven L. Moran and Alexander Y. Shin
Vascularized bone graft procedures have been applied to several maladies of the carpus
including proximal pole fractures of the scaphoid, Preiser s disease, and Kienbock s dis¬
ease. Vascularized bone grafts are capable of primary bony healing without creeping
substitution and can thus accelerate fracture healing, replace deficient bone, and revas
cularize ischemic bone. Long term data are now available to evaluate the benefits and
deficiencies of vascularized grafts in the treatment of many carpal maladies. This article
reviews the pertinent literature and provides some treatment algorithms for the use of
vascularized bone grafting in cases of carpal pathology.
The Use of Free Vascularized Corticoperiosteal Grafts from the Femur
in the Treatment of Scaphoid Non union 87
Kazuteru Doi and Yasunori Hattori
Most scaphoid non unions can be treated successfully with conventional bone graft and
screw fixation. Only a few cases with established avascular necrosis of the proximal frag¬
ment and previous failed conventional bone grafting should undergo vascularized bone
graft. Cases in which the fragments are too small to accommodate a vascularized
bone graft are better treated by alternative procedures. This article describes the role
vi CONTENTS
of vascularized bone grafting for scaphoid non union, indications, donor bone selection,
the authors operative technique for vascularized bone graft from the supracondylar re¬
gion of the femur, outcomes, and complications.
Vascularized Epiphyseal Transplant 95
Marco Innocenti, Luca Delcroix, G. Federico Romano, and Rodolfo Capanna
In skeletally immature patients, the transfer of vascularized epiphysis along with a vari¬
able amount of adjoining diaphysis may provide the potential for growth of such a graft,
preventing future limb length discrepancy. This article describes the authors experience
with the vascularized transfer of the proximal fibular epiphysis in the reconstruction of
large bone defects including the epiphysis in a series of 27 patients ranging in age from 2
to 11 years. The follow up, ranging from 2 to 14 years, has been long enough to allow
some evaluation of the validity, indications, and limits of this reconstructive option.
Microvascular Transplantation of Epiphyseal Plates: Studies Utilizing
Allograft Donor Material 103
Martin I. Boyer and C. Vaughan A. Bowen
Compromised function of an epiphyseal plate caused by trauma, tumor, infection, or
congenital malformation can result in significant musculoskeletal deformity. Techniques
used to correct or minimize the extent of these deformities include autogenous or allo
geneic cancellous bone grafts, nonvascularized cortical allografts, vascularized bone
and composite tissue transfers, and distraction osteogenesis. These solutions are not
ideal for children because they do not adequately address the actively growing nature
of the extremity. Microvascular techniques have enabled the experimental transplanta¬
tion of vascularized epiphyseal plates with high levels of postoperative viability and
subsequent growth and offer a potential advantage over conventional treatments.
Vascularized Bone Allotransplantation: Current State and Implications
for Future Reconstructive Surgery 109
Allen T. Bishop and Michael Pelzer
This article focuses on current advances in musculoskeletal tissue allotransplantation, in¬
cluding strategies for maintaining tissue viability in the face of histocompatibility mis¬
match and resulting acute and chronic rejection responses. In particular, it introduces
a novel concept developed in the authors laboratory and currently under evaluation
that may obviate the problem of chronic rejection. The authors have used therapeutic an
giogenesis to develop a host derived neoangiogenic circulation that maintains blood
flow regardless of rejection. The replacement of the allogeneic vessels together with bone
remodeling from host derived cells eventually may largely replace the allogeneic osteo
cytes and bone with native bone.
Index 123
CONTENTS vii
|
| adam_txt |
VASCULARIZED BONE GRAFTING IN ORTHOPEDIC SURGERY
CONTENTS
Preface
Alexander Y. Shin and Steven L. Moran ix
Free Vascularized Fibular Grafting—25 Years' Experience: Tips, Techniques,
and Pearls 1
Michael B. Wood
Thirty years after its introduction vascularized fibula transfer remains an important tool
for all surgeons dealing with particularly challenging bone reconstruction problems. It
should be a consideration when simpler approaches either have failed or are expected
to fail. It is particularly indicated for the reconstruction of massive bone defects asso¬
ciated with sepsis and bony non unions associated with radionecrosis. The successful ex¬
ecution of vascularized fibular grafting, however, requires microvascular expertise and
adherence to sound orthopedic principles for bone healing, including stable internal fixa¬
tion, maximal bone to bone coaptation, and appropriate postoperative management re¬
garding joint mobilization and weight bearing.
Avascular Necrosis of the Femoral Head: Role of Vascularized Bone Grafts 13
J. Mack Aldridge and James R. Urbaniak
This article presents the history and development of as well as the results from the var¬
ious techniques of vascularized bone grafting for the treatment of osteonecrosis (ON) of
the femoral head. The authors have treated more than 2600 patients who had femoral
head ON, using a vascularized fibular graft by way of an intraosseous approach. The
results from this vast experience are summarized and certain pearls and pitfalls regard¬
ing the treatment of femoral head ON using the free vascularized fibular graft are high¬
lighted.
Long Bone Reconstruction with Vascularized Bone Grafts 23
William C. Pederson and David W. Person
The vascularized fibula may be used for long bone reconstruction reliably and success¬
fully Since its description by Taylor, the fibula flap has evolved to solve a myriad of long
bone reconstructive dilemmas. The flap is used routinely for non unions, postoncologic
resections, and congenital defects. It provides faster and more reliable union than non
vascularized grafts. When constructed in a double barrel configuration, it otters the abil¬
ity to bear weight The vascularized fibula can be used to maintain growth by virtue ot
transferring the physis. The vascularized fibula is thus both the workhorse and thor¬
oughbred in long bone reconstruction.
VOLUME 38 • NUMBER 1 • JANUARY 2007 v
Role of Vascularized Bone Grafts in Lower Extremity Osteomyelitis 37
Yuan Kun Tu and Cheng Yo Yen
Vascularized bone grafting seems to be a valuable reconstructive technique for the treat¬
ment of osteomyelitis with skeletal defects greater than 6 cm in length. Fibular osteocu
taneous, composite rib, and iliac osteocutaneous flaps are the most commonly used
vascularized bone grafts clinically. Vascularized bone can obliterate dead space, bridge
large bone defects, enhance bone healing, resist infection by ensuring blood supply, al¬
low early rehabilitation, and ensure better clinical outcomes in the treatment of lower ex¬
tremity osteomyelitis. Success rates range from 80% to 95%. Complications of surgery
include anastomosis failure, donor site problems, and fracture of the grafted bone.
A New Reconstructive Technique for Intercalary Defects of Long Bones:
The Association of Massive Allograft with Vascularized Fibular Autograft.
Long Term Results and Comparison with Alternative Techniques 51
Rodolfo Capanna, Domenico A. Campanacci, Nicolas Belot, Giovanni Beltrami,
Marco Manfrini, Marco Innocenti, and Massimo Ceruso
In 1988, the excellent results obtained with the use of vascularized fibular autograft as a
salvage procedure in massive allograft failures caused by non union or massive resorp
tion prompted a trial of an original reconstructive technique for intercalary defects based
on the primary combination of the two types of graft. The authors believe the excellent
final results and the ability to avoid further salvage surgical procedures justify the pri¬
mary application of this more complicated technique despite longer surgical times.
The Role of Vascularized Bone Grafts in Spine Surgery 61
Alexander Y. Shin and Mark B. Dekutoski
The use of vascularized bone grafts in complex spine reconstruction is particularly at¬
tractive in situations that involve large segmental bone defects, failed previous attempts
at arthrodesis, poor soft tissue beds secondary to infection or radiation exposure necrosis
or failed arthrodesis in neuromuscular disease processes. This article details the indica¬
tions and rational for vascularized bone grafting as well as the results of vascularized
bone grafting of the spine.
Vascularized Bone Grafting for the Treatment of Carpal Pathology 73
Steven L. Moran and Alexander Y. Shin
Vascularized bone graft procedures have been applied to several maladies of the carpus
including proximal pole fractures of the scaphoid, Preiser's disease, and Kienbock's dis¬
ease. Vascularized bone grafts are capable of primary bony healing without creeping
substitution and can thus accelerate fracture healing, replace deficient bone, and revas
cularize ischemic bone. Long term data are now available to evaluate the benefits and
deficiencies of vascularized grafts in the treatment of many carpal maladies. This article
reviews the pertinent literature and provides some treatment algorithms for the use of
vascularized bone grafting in cases of carpal pathology.
The Use of Free Vascularized Corticoperiosteal Grafts from the Femur
in the Treatment of Scaphoid Non union 87
Kazuteru Doi and Yasunori Hattori
Most scaphoid non unions can be treated successfully with conventional bone graft and
screw fixation. Only a few cases with established avascular necrosis of the proximal frag¬
ment and previous failed conventional bone grafting should undergo vascularized bone
graft. Cases in which the fragments are too small to accommodate a vascularized
bone graft are better treated by alternative procedures. This article describes the role
vi CONTENTS
of vascularized bone grafting for scaphoid non union, indications, donor bone selection,
the authors' operative technique for vascularized bone graft from the supracondylar re¬
gion of the femur, outcomes, and complications.
Vascularized Epiphyseal Transplant 95
Marco Innocenti, Luca Delcroix, G. Federico Romano, and Rodolfo Capanna
In skeletally immature patients, the transfer of vascularized epiphysis along with a vari¬
able amount of adjoining diaphysis may provide the potential for growth of such a graft,
preventing future limb length discrepancy. This article describes the authors' experience
with the vascularized transfer of the proximal fibular epiphysis in the reconstruction of
large bone defects including the epiphysis in a series of 27 patients ranging in age from 2
to 11 years. The follow up, ranging from 2 to 14 years, has been long enough to allow
some evaluation of the validity, indications, and limits of this reconstructive option.
Microvascular Transplantation of Epiphyseal Plates: Studies Utilizing
Allograft Donor Material 103
Martin I. Boyer and C. Vaughan A. Bowen
Compromised function of an epiphyseal plate caused by trauma, tumor, infection, or
congenital malformation can result in significant musculoskeletal deformity. Techniques
used to correct or minimize the extent of these deformities include autogenous or allo
geneic cancellous bone grafts, nonvascularized cortical allografts, vascularized bone
and composite tissue transfers, and distraction osteogenesis. These solutions are not
ideal for children because they do not adequately address the actively growing nature
of the extremity. Microvascular techniques have enabled the experimental transplanta¬
tion of vascularized epiphyseal plates with high levels of postoperative viability and
subsequent growth and offer a potential advantage over conventional treatments.
Vascularized Bone Allotransplantation: Current State and Implications
for Future Reconstructive Surgery 109
Allen T. Bishop and Michael Pelzer
This article focuses on current advances in musculoskeletal tissue allotransplantation, in¬
cluding strategies for maintaining tissue viability in the face of histocompatibility mis¬
match and resulting acute and chronic rejection responses. In particular, it introduces
a novel concept developed in the authors' laboratory and currently under evaluation
that may obviate the problem of chronic rejection. The authors have used therapeutic an
giogenesis to develop a host derived neoangiogenic circulation that maintains blood
flow regardless of rejection. The replacement of the allogeneic vessels together with bone
remodeling from host derived cells eventually may largely replace the allogeneic osteo
cytes and bone with native bone.
Index 123
CONTENTS vii |
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| physical | X, 126 S. zahlr. Ill. |
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| series | Orthopedic clinics of North America |
| series2 | Orthopedic clinics of North America |
| spelling | Vascularized bone grafting in orthopedic surgery guest ed. Alexander Y. Shin ... Philadelphia [u.a.] Saunders 2007 X, 126 S. zahlr. Ill. txt rdacontent n rdamedia nc rdacarrier Orthopedic clinics of North America 38,1 Bone grafts Vascular grafts Shin, Alexander Y. Sonstige oth Orthopedic clinics of North America 38,1 (DE-604)BV000001089 38,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015450401&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Vascularized bone grafting in orthopedic surgery Orthopedic clinics of North America Bone grafts Vascular grafts |
| title | Vascularized bone grafting in orthopedic surgery |
| title_auth | Vascularized bone grafting in orthopedic surgery |
| title_exact_search | Vascularized bone grafting in orthopedic surgery |
| title_exact_search_txtP | Vascularized bone grafting in orthopedic surgery |
| title_full | Vascularized bone grafting in orthopedic surgery guest ed. Alexander Y. Shin ... |
| title_fullStr | Vascularized bone grafting in orthopedic surgery guest ed. Alexander Y. Shin ... |
| title_full_unstemmed | Vascularized bone grafting in orthopedic surgery guest ed. Alexander Y. Shin ... |
| title_short | Vascularized bone grafting in orthopedic surgery |
| title_sort | vascularized bone grafting in orthopedic surgery |
| topic | Bone grafts Vascular grafts |
| topic_facet | Bone grafts Vascular grafts |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=015450401&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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