چكيده لاتين :
BACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques,
limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with
bone tumors. One option is allograft replacement. Although allograft has several advantages, it is not without complications
. This study was performed to observe these complications in a group of patients treated with allograft replacement
for bone tumor resection. The purpose was to gain an overview of the factors predisposing to these complications to
minimize their occurrence.
METHODS: This retrospective study was performed on patients with benign aggressive and malignant bone tumors undergoing
limb reconstruction with allograft between 1997 and 2005 in AI-Zahra and Kashani Hospitals in Isfahan , Iran.
Data was collected from patient files, clinical notes, radiographs and a recent physical examination. Complications including
local recurrence, fracture of allograft, fixation failure, nonunion, infection, skin necrosis and neurological damage
were recorded.
RESULTS: Sixty patients including 39 males and 21 females were studied. The mean age of patients was 23 ± 11.7
years. The mean follow-up interval was 28.1 ± 12.4 months (mean ± SD). Complications were allograft fracture in
20%, local recurrence in 16%, fixation failure in II %, nonunion in 6%, infection in 6%, skin necrosis in 6%, and peroneal
nerve palsy in 1% of cases. Most local recurrences (60%) were those with a mal-performed biopsy . Most allograft
fractures occurred when a short plate was used.
CONCLUSIONS: Allograft replacement for bone tumors remains a valid option . To avoid complications, biopsy should
be done by a trained surgeon in bone oncology. A long plate is recommended for fixation. Sterility and graft processing
must be optimal. Autogenous bone graft must be added at host-allograft junction.
