CORAL GRAFT AS SUPPORT IN THE SURGICAL-TR EATMENT OF ARTICULAR TRAUMATIC DEPRESSION - PROSPECTIVE-STUDY ON THE LOWER-EXTREMITY IN 23 CASES

Citation
F. Deperetti et al., CORAL GRAFT AS SUPPORT IN THE SURGICAL-TR EATMENT OF ARTICULAR TRAUMATIC DEPRESSION - PROSPECTIVE-STUDY ON THE LOWER-EXTREMITY IN 23 CASES, Revue de chirurgie orthopedique et reparatrice de l'appareil moteur, 82(3), 1996, pp. 234-240
Citations number
21
Categorie Soggetti
Surgery,Orthopedics
ISSN journal
00351040
Volume
82
Issue
3
Year of publication
1996
Pages
234 - 240
Database
ISI
SICI code
0035-1040(1996)82:3<234:CGASIT>2.0.ZU;2-7
Abstract
Introduction Infection risk makes the management of a bone bank more a nd more difficult. On the other hand, realizing an autologous graft is not always without consequences. That is why we estimated the mechani cal quality, the osteo-integration and the biocompatability of a coral graft. Material and methods Between 1988 and 1992, two of us systemat ically used coral graft as ''support'' after lifting of some articular depression in fractures of inferior limb. Osteosynthesis was systemat ically associated. In this way, we operated 13 fractures of the latera l tibial plateau, 8 thalamic fractures of the calcaneus and 2 fracture s of the inferior extremity of the tibia. Average follow-up is 20 mont hs, with extremes of 68 and 12 months. Material ablation was realized 13 times and coral graft biopsy 4 times. Bone integration was estimate d radiologically in 3 stages - stage 1 : non union = ''margin'' around the coral, - stage 2 : possible integration = the coral is perfectly visible, but its borders grow indistinct, - stage 3 : certain integrat ion = peripheral disparition of the coral weft, radiological interpene tration between coral and bone framework. We systematically searched f or secondary displacements and complications. Results Mechanical condi tions were respected, there was no secondary displacement, ''Possible integration'' (stage 2) was found in 8 cases at an average follow-up o f 20 months. In 9 cases, we found ''certain integration'' (stage 3), a t an average follow-up of 28 months, It is possible that a more import ant follow-up time would allow to find more integration cases. Biocomp atibility is debatable under the operating conditions of the authors, We counted 5 aseptic serous flows which continued to be aseptic (1 tib ial plateau, 1 inferior extremity of the tibia, 3 calcaneum), Three co ral grafts were removed to obtain healing. Discussion When biocompatib ility is satisfactory the integration is certain. The longer the follo w-up time, the more stage 3 cases can be observed. Nevertheless, this integration runs out with time. We did not find any explication to ase ptic serous flows. It may result from some impurities. On the other ha nd, use of the coralin hydroxyapatite does not seem to drive to allerg ic complications. Conclusion In accordance with this study, we use the coral graft only in case of tibial plateau fracture, Our experience w ith coral graft in the other fields of bone surgery is not sufficient to express an opinion.