Application of meshy fascia encapsulating cancellous bone graft in repair of bone defect after limb fractures_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHOU Zihong ¹ , ZHAO Jijun ¹ , FENG Dehong ¹ , WU Zhaofeng ¹ ,  LIU Yu ²

1. Department of Orthopedics, Wuxi People’s Hospital, Wuxi Jiangsu, 214000, P.R.China;
2. Department of Orthopedics, Wuxi Orthopedics Hospital, Wuxi Jiangsu, 214000, P.R.China;

Corresponding author：

LIU Yu, Email: wzsyzzh@126.com

Keywords：

Bone defect; encapsulated bone graft; fascia; repair

DOI：

10.7507/1002-1892.201804071

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Objective To investigate the effectiveness of meshy fascia encapsulating cancellous bone graft in repair of bone defect after limb fractures. Methods A clinical data of 21 cases of traumatic bone defect after limb fractures, who were treated with meshy fascia encapsulating cancellous bone graft between June 2011 and December 2016, was retrospectively analyzed. There were 13 males and 8 females, aged 14-64 years with an average of 40.1 years. The location of bone defect included humerus in 3 cases, radius in 5 cases, ulna in 4 cases, femur in 2 cases, and tibia in 7 cases. AO classification of primary fractures were type A in 2 cases, type B in 7 cases, and type C in 12 cases. There were 14 cases of open fracture, and 7 cases of closed fracture associated with bone defect. The time from injury to bone defect repair was 5-165 days (mean, 21.3 days). The length of bone defect was 2.5-6.5 cm with an average of 4.5 cm. Results The operation time was 86-130 minutes (mean, 101 minutes). The intraoperative blood loss was 185-647 mL (mean, 316 mL). One case of superficial infection and 2 cases of delayed healing of incision occurred after operation, and no neurovascular injury occurred. All the 21 patients were followed up 12-36 months (mean, 19 months). The clinical healing time was 2.5-7.0 months (mean, 5.4 months); no delayed healing and nonunion occurred, the bony healing rate was 100%. There was no deep infection, infection recurrence, broken of internal fixator, or refracture. At last follow-up, the grading of bony healing were all rated as excellent, and the functional recovery of the affected limb was excellent in 12 cases, good in 7 cases, and fair in 2 cases with an excellent and good rate of 90.5%. Conclusion Meshy fascia encapsulating cancellous bone graft in repair of bone defect after limb fracture is characterized by easy to harvest fascia, simplicity of operation, no adverse reaction, lower cost, and satisfactory results.

Citation： ZHOU Zihong, ZHAO Jijun, FENG Dehong, WU Zhaofeng, LIU Yu. Application of meshy fascia encapsulating cancellous bone graft in repair of bone defect after limb fractures. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(12): 1530-1533. doi: 10.7507/1002-1892.201804071 Copy

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2.	殷渠东, 芮永军, 顾三军, 等. 改良打压游离植骨治疗长段骨缺损一例. 中国修复重建外科杂志, 2012, 26(5): 637-638.
3.	Attias N, Lindsey RW. Case reports: management of large segmental tibial defects using a cylindrical mesh cage. Clin Orthop Relat Res, 2006, 450: 259-266.
4.	Cobos JA, Lindsey RW, Gugala Z. The cylindrical titanium mesh cage for treatment of a long bone segmental defect: description of a new technique and report of two cases. J Orthop Trauma, 2000, 14(1): 54-59.
5.	Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet, 2000, 45(3): 346-353.
6.	邱旭升, 陈一心, 戚晓阳, 等. 诱导膜技术治疗感染性骨缺损的疗效分析. 中国修复重建外科杂志, 2017, 31(9): 1064-1068.
7.	田文, 吴玮伟, 王富明, 等. 网状植骨治疗股骨中下段大段骨缺损的临床应用. 生物骨科材料与临床研究, 2012, 9(6): 41-44.
8.	刘尧喜, 梅海波, 刘昆, 等. 四合一骨融合术在儿童先天性胫骨假关节联合手术中的应用. 中华骨科杂志, 2016, 36(12): 770-777.
9.	张辉, 许亚军, 陈政, 等. 线捆绑游离皮质骨块包裹松质骨植骨治疗胫骨节段性骨缺损疗效. 中国现代医学杂志, 2017, 27(8): 109-113.
10.	殷渠东, 顾三军, 芮永军, 等. 松质骨包裹植骨技术治疗长骨节段性骨缺损. 中华创伤骨科杂志, 2017, 19(9): 775-781.
11.	顾春杨. 自体筋膜在复合植骨材料修复骨缺损中的作用. 辽宁锦州: 锦州医学院, 2004.
12.	王辉, 王茜, 张辉, 等. 带蒂筋膜瓣包裹国产多孔钽修复兔桡骨节段性骨缺损实验研究. 中国修复重建外科杂志, 2017, 31(10): 1200-1207.
13.	Paley D, Herzenberg JE, Paremain G, et al. Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg (Am), 1997, 79(10): 1464-1480.
14.	Whately C, Abdallah MA, Alwatari YA. Management of large segmental tibial defects using locking IM nail and absorbable mesh. BMJ Case Rep, 2013, 2013. pii: bcr2013010480.
15.	汪小华, 傅景曙, 沈杰, 等. 膜诱导技术治疗胫骨创伤后骨髓炎. 中华创伤杂志, 2015, 31(4): 299-302.

1. 左伟, 孙伟, 高福强, 等. 经头颈部开窗打压植骨治疗股骨头已部分塌陷股骨头坏死疗效分析. 中国修复重建外科杂志, 2016, 30(4): 397-401.
2. 殷渠东, 芮永军, 顾三军, 等. 改良打压游离植骨治疗长段骨缺损一例. 中国修复重建外科杂志, 2012, 26(5): 637-638.
3. Attias N, Lindsey RW. Case reports: management of large segmental tibial defects using a cylindrical mesh cage. Clin Orthop Relat Res, 2006, 450: 259-266.
4. Cobos JA, Lindsey RW, Gugala Z. The cylindrical titanium mesh cage for treatment of a long bone segmental defect: description of a new technique and report of two cases. J Orthop Trauma, 2000, 14(1): 54-59.
5. Masquelet AC, Fitoussi F, Begue T, et al. Reconstruction of the long bones by the induced membrane and spongy autograft. Ann Chir Plast Esthet, 2000, 45(3): 346-353.
6. 邱旭升, 陈一心, 戚晓阳, 等. 诱导膜技术治疗感染性骨缺损的疗效分析. 中国修复重建外科杂志, 2017, 31(9): 1064-1068.
7. 田文, 吴玮伟, 王富明, 等. 网状植骨治疗股骨中下段大段骨缺损的临床应用. 生物骨科材料与临床研究, 2012, 9(6): 41-44.
8. 刘尧喜, 梅海波, 刘昆, 等. 四合一骨融合术在儿童先天性胫骨假关节联合手术中的应用. 中华骨科杂志, 2016, 36(12): 770-777.
9. 张辉, 许亚军, 陈政, 等. 线捆绑游离皮质骨块包裹松质骨植骨治疗胫骨节段性骨缺损疗效. 中国现代医学杂志, 2017, 27(8): 109-113.
10. 殷渠东, 顾三军, 芮永军, 等. 松质骨包裹植骨技术治疗长骨节段性骨缺损. 中华创伤骨科杂志, 2017, 19(9): 775-781.
11. 顾春杨. 自体筋膜在复合植骨材料修复骨缺损中的作用. 辽宁锦州: 锦州医学院, 2004.
12. 王辉, 王茜, 张辉, 等. 带蒂筋膜瓣包裹国产多孔钽修复兔桡骨节段性骨缺损实验研究. 中国修复重建外科杂志, 2017, 31(10): 1200-1207.
13. Paley D, Herzenberg JE, Paremain G, et al. Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg (Am), 1997, 79(10): 1464-1480.
14. Whately C, Abdallah MA, Alwatari YA. Management of large segmental tibial defects using locking IM nail and absorbable mesh. BMJ Case Rep, 2013, 2013. pii: bcr2013010480.
15. 汪小华, 傅景曙, 沈杰, 等. 膜诱导技术治疗胫骨创伤后骨髓炎. 中华创伤杂志, 2015, 31(4): 299-302.

Chinese Journal of Reparative and Reconstructive Surgery

Application of meshy fascia encapsulating cancellous bone graft in repair of bone defect after limb fractures

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