The related factors for bone healing of segmental allografts

Objective To evaluate the clinical efficacy of reconstruction with segmental allografts in the treatment of bone tumors, and to analyze the related factors affecting the bone healing of the allografts. Methods The clinical data of 17 patients with bone tumors who received large allograft bone grafting in the Affiliated Tumor Hospital of Zhengzhou University from May 2007 to January 2016 were retrospectively analyzed. The 17 patients included 9 males and 8 females. The patients were aged from 11 to 45 years. Surgical site: 9 patients of femur, 6 patients of humerus, 2 patients of tibia. Bone length: 8 cm to 28 cm, mean (16.8±4.0) cm. Internal fixation: 8 patients of steel plate screws, 9 patients of intramedullary needles. According to the situation of allograft healing, 10 patients were divided into the unhealed group (including 4 patients of allograft fracture, 2 patients of allograft infection) and 7 patients in the healing group. The differences of gender, age, surgical site, internal fixation, length of allogeneic bone, chemotherapy and postoperative allogeneic bone infection between the two groups were compared. Results The follow-up period was 2-10 years. Ten patients had bone nonunion (including 4 patients with allograft fracture, 2 patients with allograft infection). The rest seven patients achieved bone union. The average union time was 27 (15-43)months. Compared with the unhealed group and the healing group, there was statistical difference in the internal fixation mode between the two groups (P=0.015). There were no statistical differences in the other clinical features(all P values>0.05). Conclusions The intramedullary nail fixation is an unfavorable factor for the bone healing after allograft reconstruction. Key words: Bone neoplasms; Bone transplantation allograft; Bone healing; Bone plate; Intramedullary nail