Tricortical-allobone Grafting in Screw Fixation for Intra-articular Calcaneal Fracture via Ollier Approach / 대한족부족관절학회지

PURPOSE: Bone grafting is often necessary to maintain a reduction and prevent delayed collapse of reduced fracture in a treatment of severely displaced comminuted intra-articular calcaneal fractures. Herein, we analyzed the usefulness and necessary conditions to perform tricortical-allobone grafting in open reduction of calcaneal fracture via the Ollier approach. MATERIALS AND METHODS: We performed a retrospective review of 57 intra-articular calcaneal fractures that underwent an operation via the Ollier approach between April 2009 and April 2015. They were divided into two groups: Group 1 (n=17) included those with tricortical-allobone grafts underneath the posterior facet fragment, and group 2 (n=40) included cases without a bone graft. We measured the Böhler angle, Gissane angle, height, and width of the calcaneus at preoperative, postoperative, and final follow-up radiograph. We measured the sagittal rotational angle of the posterior facet fragment of preoperative computed tomography to analyze the effect and necessary conditions for bone grafting. We also reviewed the clinical results by the American Orthopaedic Foot and Ankle Society (AOFAS) scale, visual analogue scale (VAS), and any complications. RESULTS: According to the Sanders classification, there were 3 type-II fractures, 12 type-III fractures, and 2 type-IV fractures in Group 1; whereas in Group 2, there were 26 type-II fractures, 13 type-III fractures, and 1 type-IV fracture (p=0.002). Regarding the preoperative radiologic parameters, there were significant differences in the Böhler angle (p=0.006), Gissane angle (p=0.043), and rotational angle of the posterior facet fragment (p=0.001). No significant difference was observed in the preoperative calcaneal height and width, as well as postoperative radiologic parameters. There was no significant clinical difference between the two groups (p=0.546). CONCLUSION: We suggest that a tricortical-allobone graft may be useful in open reduction and screw fixation via the Ollier approach for displaced intra-articular calcaneal fracture with a bony defect after reduction of collapsed posterior facet fragment. This graft can contribute to the stable reduction via a small approach, even without a plate.

Comparison of the Result of Lumbar Posterolateral Bone Fusion using Autogenous Bone Graft with Allobone Graft

OBJECTIVE: The purpose of this study is to analyze clinical outcome of lumbar spinal fusion with autobone graft and with allobone graft as an additional autograft extender. METHODS: Fifty two patients who underwent lumbar posterolateral arthrodesis for degenerative lumbar diseases between February, 1998 and October, 2000 were evaluated. Arthrodesis was performed by transpedicular screw fixation. We used autogenous bone graft in 32 cases (Group A) and allobone graft in 20 cases (group B). Post operative radiographs were obtained to review the resorption of graft bone and the evidence of fusion. A modified Lenke scale was used to assess the status of the fusion. RESULTS: There were 17 men and 35 women. Mean follow up period was 12 months. According to the modified Lenke scale, spinal bone fusion rate was 93.75% in the group A and 85% in the groub B. CONCLUSION: Lumbar spinal fusion using allobone graft is favorably good compare to autobone graft.