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

Video：

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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

1.	左偉, 孫偉, 高福強, 等. 經頭頸部開窗打壓植骨治療股骨頭已部分塌陷股骨頭壞死療效分析. 中國修復重建外科雜志, 2016, 30(4): 397-401.
2.	殷渠東, 芮永軍, 顧三軍, 等. 改良打壓游離植骨治療長段骨缺損一例. 中國修復重建外科雜志, 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, 陳一心, 戚曉陽, 等. 誘導膜技術治療感染性骨缺損的療效分析. 中國修復重建外科雜志, 2017, 31(9): 1064-1068.
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8.	劉堯喜, 梅海波, 劉昆, 等. 四合一骨融合術在兒童先天性脛骨假關節聯合手術中的應用. 中華骨科雜志, 2016, 36(12): 770-777.
9.	張輝, 許亞軍, 陳政, 等. 線捆綁游離皮質骨塊包裹松質骨植骨治療脛骨節段性骨缺損療效. 中國現代醫學雜志, 2017, 27(8): 109-113.
10.	殷渠東, 顧三軍, 芮永軍, 等. 松質骨包裹植骨技術治療長骨節段性骨缺損. 中華創傷骨科雜志, 2017, 19(9): 775-781.
11.	顧春楊. 自體筋膜在復合植骨材料修復骨缺損中的作用. 遼寧錦州: 錦州醫學院, 2004.
12.	王輝, 王茜, 張輝, 等. 帶蒂筋膜瓣包裹國產多孔鉭修復兔橈骨節段性骨缺損實驗研究. 中國修復重建外科雜志, 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.	汪小華, 傅景曙, 沈杰, 等. 膜誘導技術治療脛骨創傷后骨髓炎. 中華創傷雜志, 2015, 31(4): 299-302.

1. 左偉, 孫偉, 高福強, 等. 經頭頸部開窗打壓植骨治療股骨頭已部分塌陷股骨頭壞死療效分析. 中國修復重建外科雜志, 2016, 30(4): 397-401.
2. 殷渠東, 芮永軍, 顧三軍, 等. 改良打壓游離植骨治療長段骨缺損一例. 中國修復重建外科雜志, 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, 陳一心, 戚曉陽, 等. 誘導膜技術治療感染性骨缺損的療效分析. 中國修復重建外科雜志, 2017, 31(9): 1064-1068.
7. 田文, 吳瑋偉, 王富明, 等. 網狀植骨治療股骨中下段大段骨缺損的臨床應用. 生物骨科材料與臨床研究, 2012, 9(6): 41-44.
8. 劉堯喜, 梅海波, 劉昆, 等. 四合一骨融合術在兒童先天性脛骨假關節聯合手術中的應用. 中華骨科雜志, 2016, 36(12): 770-777.
9. 張輝, 許亞軍, 陳政, 等. 線捆綁游離皮質骨塊包裹松質骨植骨治療脛骨節段性骨缺損療效. 中國現代醫學雜志, 2017, 27(8): 109-113.
10. 殷渠東, 顧三軍, 芮永軍, 等. 松質骨包裹植骨技術治療長骨節段性骨缺損. 中華創傷骨科雜志, 2017, 19(9): 775-781.
11. 顧春楊. 自體筋膜在復合植骨材料修復骨缺損中的作用. 遼寧錦州: 錦州醫學院, 2004.
12. 王輝, 王茜, 張輝, 等. 帶蒂筋膜瓣包裹國產多孔鉭修復兔橈骨節段性骨缺損實驗研究. 中國修復重建外科雜志, 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. 汪小華, 傅景曙, 沈杰, 等. 膜誘導技術治療脛骨創傷后骨髓炎. 中華創傷雜志, 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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