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Comparison of Surface Area across the Allograft-Host Junction Site Using Conventional and Navigated Osteotomy Technique.

Lall A, Hohn E, Kim MY, Gorlick RG, Abraham JA, Geller DS - Sarcoma (2012)

Bottom Line: Compared with a control of 0.69 square inches, average contact area was found to be 30.5% of optimal surface contact.Compared with a control of 0.76 square inches, average contact area was found to be 43.7% of optimal surface contact.Limited contact achieved using standard techniques may play a role in the high rate of observed non-union, and an increase in contact area using computer-assisted navigation may improve rates of bone healing.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Montefiore Medical Center, The Children's Hospital at Montefiore, Bronx, NY 10467, USA ; The Albert Einstein College of Medicine, Bronx, NY 10461, USA.

ABSTRACT
Bulk allograft reconstruction plays an important role in limb-salvage surgery; however, non-union has been reported in up to 27% of cases. The purpose of this study is to quantify average surface contact areas across simulated intraoperative osteotomies using both free-hand and computer-assisted navigation techniques. Pressure-sensitive paper was positioned between two cut ends of a validated composite sawbone and compression was applied using an eight-hole large fragment dynamic compression plate. Thirty-two samples were analyzed for surface area contact to determine osteotomy congruity. Mean contact area using the free-hand osteotomy technique was equal to 0.21 square inches. Compared with a control of 0.69 square inches, average contact area was found to be 30.5% of optimal surface contact. Mean contact area using computer-assisted navigation was equal to 0.33 square inches. Compared with a control of 0.76 square inches, average contact area was found to be 43.7% of optimal surface contact. Limited contact achieved using standard techniques may play a role in the high rate of observed non-union, and an increase in contact area using computer-assisted navigation may improve rates of bone healing. The development of an oncology software package and navigation hardware may serve an important role in decreasing non-union rates in limb salvage surgery.

No MeSH data available.


Related in: MedlinePlus

Scanned raw images of PRESSUREX film after contact at the allograft-host junction site made using the free-hand technique. Of the 32 samples, contact area achieved is seen in red for control (ideal) at 0.69 sq. in. (a), minimal contact at 0.07 sq. in. (b), and maximal contact at 0.36 sq. in. (c).
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fig3: Scanned raw images of PRESSUREX film after contact at the allograft-host junction site made using the free-hand technique. Of the 32 samples, contact area achieved is seen in red for control (ideal) at 0.69 sq. in. (a), minimal contact at 0.07 sq. in. (b), and maximal contact at 0.36 sq. in. (c).

Mentions: Analysis of the 32 Pressurex samples using the free-hand technique showed a mean contact area of 0.21 sq. in. (range 0.07 to 0.36). As shown in Figure 3, compared with a control of 0.69 sq. in., the mean contact area represents 30.5% of optimal surface contact (range 10.1% to 52.2%) (Table 2).


Comparison of Surface Area across the Allograft-Host Junction Site Using Conventional and Navigated Osteotomy Technique.

Lall A, Hohn E, Kim MY, Gorlick RG, Abraham JA, Geller DS - Sarcoma (2012)

Scanned raw images of PRESSUREX film after contact at the allograft-host junction site made using the free-hand technique. Of the 32 samples, contact area achieved is seen in red for control (ideal) at 0.69 sq. in. (a), minimal contact at 0.07 sq. in. (b), and maximal contact at 0.36 sq. in. (c).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539445&req=5

fig3: Scanned raw images of PRESSUREX film after contact at the allograft-host junction site made using the free-hand technique. Of the 32 samples, contact area achieved is seen in red for control (ideal) at 0.69 sq. in. (a), minimal contact at 0.07 sq. in. (b), and maximal contact at 0.36 sq. in. (c).
Mentions: Analysis of the 32 Pressurex samples using the free-hand technique showed a mean contact area of 0.21 sq. in. (range 0.07 to 0.36). As shown in Figure 3, compared with a control of 0.69 sq. in., the mean contact area represents 30.5% of optimal surface contact (range 10.1% to 52.2%) (Table 2).

Bottom Line: Compared with a control of 0.69 square inches, average contact area was found to be 30.5% of optimal surface contact.Compared with a control of 0.76 square inches, average contact area was found to be 43.7% of optimal surface contact.Limited contact achieved using standard techniques may play a role in the high rate of observed non-union, and an increase in contact area using computer-assisted navigation may improve rates of bone healing.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Montefiore Medical Center, The Children's Hospital at Montefiore, Bronx, NY 10467, USA ; The Albert Einstein College of Medicine, Bronx, NY 10461, USA.

ABSTRACT
Bulk allograft reconstruction plays an important role in limb-salvage surgery; however, non-union has been reported in up to 27% of cases. The purpose of this study is to quantify average surface contact areas across simulated intraoperative osteotomies using both free-hand and computer-assisted navigation techniques. Pressure-sensitive paper was positioned between two cut ends of a validated composite sawbone and compression was applied using an eight-hole large fragment dynamic compression plate. Thirty-two samples were analyzed for surface area contact to determine osteotomy congruity. Mean contact area using the free-hand osteotomy technique was equal to 0.21 square inches. Compared with a control of 0.69 square inches, average contact area was found to be 30.5% of optimal surface contact. Mean contact area using computer-assisted navigation was equal to 0.33 square inches. Compared with a control of 0.76 square inches, average contact area was found to be 43.7% of optimal surface contact. Limited contact achieved using standard techniques may play a role in the high rate of observed non-union, and an increase in contact area using computer-assisted navigation may improve rates of bone healing. The development of an oncology software package and navigation hardware may serve an important role in decreasing non-union rates in limb salvage surgery.

No MeSH data available.


Related in: MedlinePlus