Bone Abstracts

Objectives: Allografting is often used in the surgical treatment of skeletal deformities in children’s orthopedics. The aim of our study was to investigate the response of child bone tissue to the cortical and cortico-cancellous allografting, the dynamics of remodelling in various areas of the skeleton.

Methods: Bone grafting was applied in 166 children over 3 years in the department of orthopedics and traumatology. 93 had foot deformities, 33 – benign skeletal tumors and dysplastic processes, 17 – bone fractures with delayed union, 13 – dysplasia and other disorders of the hip, 10 – congenital and acquired deformities of the long bones including bone shortening. Allografts were used most frequently during: heel bone procedures – 54 children, metatarsals – 42, femur – 18. Analysis of graft reconstruction and recovery of bone was performed by examining radiographs at 1, 3 months, then every 6 months until complete resorption.

Results: The results were observed in 140 children in the period from 1 month to 3 years. Good early results observed in 137 children. Complications occurred in 4 children: 1 – nonunion, 1 – allograft migration, 1 – chronic osteomyelitis, which required removal of the graft, and long-term treating. X-ray observation showed that significant changes in the structure of cortical grafts did not occur within the first 6 months and they provided effective mechanical correction in osteotomy or resection zone. The first symptoms of partial resorption appeared after 6 months. Complete resorption with replacement of graft with recipient bone occured in most cases after 2.5–3 years.

Conclusion: Cortical and cortico-cancellous allografts did not render pathological effects on the bone regeneration in the area of use. We found no significant difference in terms of consolidation of the fragments after surgery using cortico-cancellous and cortical allografts. Allografts provided effective mechanical correction in zone of osteotomy or bone resection within 6 months, however, required a minimal fixation. Perforation of the cortical plate is recommended, if acceleration of resorption is necessary, however, there is the possibility of loss of strength. We consider that the further use of bone alloplasty is appropriate in treating children when the need to fill bone defects or to fixate the fragments present.

Disclosure: The authors declared no competing interests.