MyMedR

Reconstruction of a tibial defect with a previously fractured fibula including the fractured segment as a free osteoseptocutaneous flap

Sadek AF, Halim AS, Ismail FW, Imran YM

Ann Plast Surg, 2014 Oct;73(4):402-4.

PMID: 23851368 DOI: 10.1097/SAP.0b013e31827fb387

Reconstruction of major bone defects using free fibular transfer provides a good biological option in unsound situations. Most authors recommend selection of the recipient blood vessels outside the zone of injury to achieve successful free fibular transfer. Occasionally, in polytraumatized patients, the surgeon has to use a previously fractured fibula as a graft, with increased risk of inclusion of the injury zone that may lead to failure.

Matched MeSH terms: Bone Transplantation/methods*

Platelet-rich plasma (PRP) enhances bone healing in non-united critical-sized defects: a preliminary study involving rabbit models

Kanthan SR, Kavitha G, Addi S, Choon DS, Kamarul T

Injury, 2011 Aug;42(8):782-9.

PMID: 21329922 DOI: 10.1016/j.injury.2011.01.015

The use of bone grafts in treating non- or delayed unions as the result of large bone loss is well established. However, despite good outcomes, the time to achieve complete union is still considerably long. To overcome this problem, the use of platelet-rich plasma (PRP) has been advocated albeit with varying success. To determine the true effectiveness of PRP in treating non-/delayed unions, a study was conducted using (n=12) rabbit models.

Matched MeSH terms: Bone Transplantation/methods

Successful commercialisation of locally fabricated bioceramics for clinical applications

Fazan F, Besar I, Osman A, Samsudin AR, Khalid KA

Med J Malaysia, 2008 Jul;63 Suppl A:49-50.

PMID: 19024978

This paper chronicled the development of a locally produced bone graft substitute based on calcium phosphate bioceramics called "GranuMaS--from concepts to clinics, and finally to its successful commercialization all within 5-year duration. It was a Prioritized Research (PR) collaborative project of 5 institutions namely SIRIM, ANM, USM, UKM and IIUM, funded by MOSTI to the amount of approximately RM2.5 millions under RM8. This paper also highlighted the requirements needed in terms of technical expertise/manpower, facilities and infrastructure, and government/institutional supports, as well as the challenge faced in developing and commercializing such product.

Matched MeSH terms: Bone Transplantation/methods

Unusual clinical presentation of a severely protruding premaxilla in patient with bilateral clefts

Burezq H, Bang RL, George A, Mukhtar A

J Craniofac Surg, 2007 Jul;18(4):971-4.

PMID: 17667698

Prominent premaxilla is one of the problems encountered when dealing with bilateral complete cleft lip and palate patients. Secondary alveolar bone grafting with these patients would achieve filling of the osseous defect, supports the alar base, eliminate the oro-nasal fistula and enhance the maxillary instability. This article describes the management of a bilateral cleft lip and palate patient with an extremely protruding premaxilla done in one stage surgery. To our knowledge, this is the first report of such degree of severity in the English literature.

Matched MeSH terms: Bone Transplantation/methods

Fulltext Revision total hip arthroplasty using impaction bone grafting technique

Nisar A, Choon DS, Varaprasad M, Abbas AA

Med J Malaysia, 2006 Feb;61 Suppl A:100-2.

PMID: 17042242

A variety of reconstructive options exist for revision of both femoral and acetabular components in total hip replacement surgery. The use of impaction bone grafting with morsellised allograft has shown promising results in revision total hip arthroplasty. It works as a biologic reconstitution of bone stock defects and provides a solid construct with stable fixation. We present a case of bilateral revision total hip arthroplasty with poor bone stock where reconstructive surgery was done by using impaction bone grafting, mesh and C-stem implants.

Matched MeSH terms: Bone Transplantation/methods*

An endeavour from porous to 3D constructs bioceramics

Idris B, Rusnah M, Reusmaazran YM, Rohaida CH

Med J Malaysia, 2004 May;59 Suppl B:67-8.

PMID: 15468822

Matched MeSH terms: Bone Transplantation/methods*

Fulltext Which is the best method of sterilization for recycled bone autograft in limb salvage surgery: a radiological, biomechanical and histopathological study in rabbit

Yasin NF, Ajit Singh V, Saad M, Omar E

BMC Cancer, 2015;15:289.

PMID: 25884718 DOI: 10.1186/s12885-015-1234-9

Limb salvage surgery is a treatment of choice for sarcomas of the extremities. One of the options in skeletal reconstruction after tumour resection is by using a recycled bone autograft. The present accepted methods of recycling bone autografts include autoclaving, pasteurization and irradiation. At the moment there is lack of studies that compare the effectiveness of various sterilization methods used for recycling bone autografts and their effects in terms of bone incorporation. This study was performed to determine the effects of different methods of sterilization on bone autografts in rabbit by radiological, biomechanical and histopathological evaluations.

Matched MeSH terms: Bone Transplantation/methods*

Use of bovine xenograft in reconstruction of traumatic anterior cranial fossa bone defects involving the frontal sinus

Abdullah J, Rushdan A, Hamzah M, Ariff AR, Rani A

Ann. Transplant., 1999;4(3-4):28-31.

PMID: 10853777

Four patients underwent reconstruction of anterior cranial fossa of skull defects between November 1997 and January 1998. All of them had traumatic anterior cranial fossa defect and were reconstructed with lyophilised bovine cortical bone graft. There was no cerebrospinal fluid leakage, meningitis, extradural abscess or other infections. This study demonstrates that the use of bovine bone graft in the reconstruction of anterior base defects is safe.

Matched MeSH terms: Bone Transplantation/methods*

Radiological results of Shelf acetabuloplasty in adolescent hip dysplasia with aspherical femoral head: how to get an ideal placement of the Shelf graft

Ramdhan Ibrahim MA, Kamegaya M, Morita M, Saisu T, Kakizaki J, Oikawa Y

J Pediatr Orthop B, 2020 May;29(3):261-267.

PMID: 31688334 DOI: 10.1097/BPB.0000000000000681

Shelf acetabuloplasty continues to be effective in the prevention or delay of osteoarthritis in adolescent dysplastic hips. We aimed to evaluate the efficacy and to determine the correct level of the bone graft objectively. We retrospectively analyzed 16 hips underwent Shelf acetabuloplasty originated by Spitzy. The mean age at surgery was 15.3 years old with the mean caput index at 39.7%. The average follow-up was 11 years. The radiological evaluation was based on acetabular-head index (AHI) at preoperative and latest radiographs, acetabular-Shelf distance (ASD) and Shelf-head ratio at immediate postoperative and latest radiographs. The cutoff value for the ideal ASD was determined by receiver operating characteristic (ROC) and the Pearson correlation test used in statistical analysis to assess the relationship between ASD and Shelf graft resorption. Clinical evaluation was performed using Harris Hip Score (HHS) at the latest follow-up. The AHI was improved in all cases, from mean 56.9 to 91.0% (P bone resorption over time was at the level of 6 mm from the joint space. Level III - therapeutic study.

Matched MeSH terms: Bone Transplantation/methods*

A Case of Non-Union of Ulna Fracture Managed with Tibial Strut Cortico-Cancellous Bone Grafting in a Paediatric Patient

Looi CSK, S A R, Gill RS

J Hand Surg Asian Pac Vol, 2017 Sep;22(3):396-402.

PMID: 28774257 DOI: 10.1142/S0218810417720327

Forearm fractures in children complicated with non-union are uncommon. Various methods have previously been reported to manage this condition. Well documented techniques would include iliac crest grafting, cancellous insert grafting, ulnar segment grafting, cortical tibial grafting, vascularized fibular grafting and bone transport by ring fixation. The authors present a case of a child with an atrophic non-union of the ulna who was successfully treated with a cortico-cancellous tibial strut bone graft.

Matched MeSH terms: Bone Transplantation/methods*

Using tissue engineering techniques for osteochondral repair and regeneration

Goh JC, Shao XX, Hutmacher D, Lee EH

Med J Malaysia, 2004 May;59 Suppl B:17-8.

PMID: 15468797

Matched MeSH terms: Bone Transplantation/methods*

Long-term effect on foot and ankle donor site following vascularized fibular graft resection in children

Sulaiman AR, Wan Z, Awang S, Che Ahmad A, Halim AS, Ahmad Mohd Zain R

J Pediatr Orthop B, 2015 Sep;24(5):450-5.

PMID: 26049965 DOI: 10.1097/BPB.0000000000000197

This study was carried out to evaluate the long-term effect on the donor side of the foot and ankle following vascularized fibular graft resection in children. Eight patients underwent resection of the fibula for the purpose of a vascularized fibular graft by a surgical team who practiced leaving at least 6 cm residual distal fibula. The age of these children at the time of surgery was between 3 and 12 years. They were reviewed between 3 and 12 years after surgery. Two patients who underwent resection of the middle shaft of the fibula at 3 and 5 years of age developed abnormal growth of the distal tibia, leading to ankle valgus. They were treated with growth modulation of the distal tibial physis and supramalleolar osteotomy with tibiofibular synostosis. Another patient who underwent the entire proximal fibula resection at the age of 6 years had developed hindfoot valgus because of weakness of the tibialis posterior muscle. He required talonavicular fusion and flexor hallucis to tibialis posterior muscle transfer. Patients operated at the age of older than 8 years neither had ankle nor hindfoot deformity. We concluded that resection of the middle shaft of the fibula for the purpose of a vascularized fibula graft, leaving a 6 cm distal fibular stump in children younger than 6 years old, may give rise to abnormal growth of the distal tibial physis, leading to valgus ankle. The entire proximal fibular resection for the similar purpose in a 6-year-old child may give rise to weakness of tibialis posterior and hindfoot valgus.

Matched MeSH terms: Bone Transplantation/methods*

Dislocation of cervico-thoracic spine with no neurological deficit--a case report

Saw A, Sengupta S

Injury, 2001 Jun;32(5):430-2.

PMID: 11382432

Matched MeSH terms: Bone Transplantation/methods

Fulltext A comparative study on morphochemical properties and osteogenic cell differentiation within bone graft and coral graft culture systems

Puvaneswary S, Balaji Raghavendran HR, Ibrahim NS, Murali MR, Merican AM, Kamarul T

Int J Med Sci, 2013;10(12):1608-14.

PMID: 24151432 DOI: 10.7150/ijms.6496

The objective of this study was to compare the morphological and chemical composition of bone graft (BG) and coral graft (CG) as well as their osteogenic differentiation potential using rabbit mesenchymal stem cells (rMSCs) in vitro. SEM analysis of BG and CG revealed that the pores in these grafts were interconnected, and their micro-CT confirmed pore sizes in the range of 107-315 µm and 103-514 µm with a total porosity of 92% and 94%, respectively. EDS analysis indicated that the level of calcium in CG was relatively higher than that in BG. FTIR of BG and CG confirmed the presence of functional groups corresponding to carbonyl, aromatic, alkyl, and alkane groups. XRD results revealed that the phase content of the inorganic layer comprised highly crystalline form of calcium carbonate and carbon. Atomic force microscopy analysis showed CG had better surface roughness compared to BG. In addition, significantly higher levels of osteogenic differentiation markers, namely, alkaline phosphatase (ALP), Osteocalcin (OC) levels, and Osteonectin and Runx2, Integrin gene expression were detected in the CG cultures, when compared with those in the BG cultures. In conclusion, our results demonstrate that the osteogenic differentiation of rMSCs is relatively superior in coral graft than in bone graft culture system.

Matched MeSH terms: Bone Transplantation/methods*

Combination of vascularized outer-table calvarial bone graft based on the superficial temporal vessels and allomatrix for the repair of an orbito-frontal blow-out fracture in a child

Ali F, Halim AS, Najihah SZ, Ibrahim M, Abdullah J

J Craniomaxillofac Surg, 2005 Oct;33(5):326-30.

PMID: 16125400

A vascularized outer-table calvarial bone graft was used for repairing a Posnick type 2 traumatic orbito-frontal bone defect supported by the use of a calcium-based putty (Allomatrix) in a 7-year-old girl. Gaps between the donor and recipient sites were filled with Allomatrix containing demineralized bone matrix particles. Four years later there was a good cosmetic result using an artificial left eye.

Matched MeSH terms: Bone Transplantation/methods*

Revision of total hip arthroplasty using an anterior cortical window, extensive strut allografts, and an impaction graft: follow-up study

Arif M, Sivananthan S, Choon DS

J Orthop Surg (Hong Kong), 2004 Jun;12(1):25-30.

PMID: 15237118

To report the outcome of revised total hip arthroplasty procedures involving an anterior cortical window, extensive strut allografts, and an Exeter impaction graft.

Matched MeSH terms: Bone Transplantation/methods*

Surgical Reconstruction of an Open Medial Malleolus Fracture Using a Novel Technique: A Case Report

Kow RY, Yuen JC, Ahmad Alwi AA, Abas MF, Low CL

JBJS Case Connect, 2019 6 25;9(2):e0163.

PMID: 31233428 DOI: 10.2106/JBJS.CC.18.00163

CASE: A 17-year-old male sustained an open fracture of the right medial malleolus (MM) with significant bone and soft tissue loss following a motor-vehicle accident. Following serial wound debridement, his ankle was effectively reconstructed with MM antiglide plate stabilization, iliac autogenous bone graft, and a free radial forearm soft tissue flap.

CONCLUSIONS: Open MM fracture with bone and soft tissue loss is rare. It is feasible to treat this injury with a novel surgical reconstruction technique involving autogenous bicortical iliac bone graft and radial forearm free flap.

Matched MeSH terms: Bone Transplantation/methods

Congenital pseudoarthrosis of the tibia: healing by lengthening over a rod without compression of the nonunion. A preliminary report

Muhammad Abdul Jamil MK, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2013 May;22(3):207-12.

PMID: 22182834 DOI: 10.1097/BPB.0b013e32834ecc01

This preliminary report is on two patients with congenital pseudoarthrosis of the tibia who had a persistent nonunion following intramedullary rodding and bone grafting. We do not advocate repeated surgery to achieve union. When limb length discrepancy becomes greater than 5 cm, we proceeded with an Ilizarov procedure with the primary aim of equalizing limb length rather than achieving union. Healing of the pseudoarthrosis occurred in both patients after lengthening over the intramedullary rod without compression of the nonunion site. We believe that union occurs because of hyperaemia during the lengthening. This approach minimizes the repeated surgeries that are usually needed and thus ensures a more normal childhood without frequent hospitalizations.

Matched MeSH terms: Bone Transplantation/methods

Composite vascularised osteocutaneous fibula and sural nerve graft for severe open tibial fracture--functional outcome at one year: a case report

Halim AS, Yusof I

J Orthop Surg (Hong Kong), 2004 Jun;12(1):110-3.

PMID: 15237132

Management of severe open tibial fracture with neurovascular injury is difficult and controversial. Primary amputation is an acceptable option as salvaging the injured, insensate, and ischaemic limb may result in chronic osteomyelitis and non-functional limb. We report a case of open tibial fracture associated with segmental bone and soft tissue loss, posterior tibial nerve and artery injuries, which was further complicated by chronic osteo-myelitis treated with composite vascularised osteocutaneous fibula and sural nerve graft. Functional outcome of the injured limb at one-year follow-up was satisfactory: the patient was capable of achieving full weightbearing and was able to appreciate crude touch, pain, proprioception, and temperature at the plantar aspect of the foot. There was no pressure sore or ulceration.

Matched MeSH terms: Bone Transplantation/methods*

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