A comparative study of allograft versus autograft grafting in tibial plateau fracture / 中国矫形外科杂志

ABSTRACT

[Objective]To study the indication and methods of bone grafts used in tibial plateau fracture and compare the character of allograft with autograft.[Method]A retrospective study was done in 105 cases of hospitalized from Jan.2000 to Aug.2004.Seventy-four cases accepted bone graft.These 74 cases were divided into two groups.Patienets in group A accepted autograft (n=40),the patients were 19 to 75 years old,with a mean age of 45.3 years.Among them,there were Schatzker type Ⅱ in 13 cases,type Ⅲ 13 cases,type Ⅳ 5 cases,type Ⅴ 4cases,type Ⅵ 5 cases.Patients in group B accepted allograft(n=34),the patients were 21 to 74 years old,with a mean age of 43.6 years,including Schatzker type Ⅱ in 12 cases,type Ⅲ 11 cases,type PC 3 cases,type Ⅴ 4 cases,type Ⅵ 4 cases,We have straight longitudinal and parapatellar incision,fixed with semiscrewed、L-plate、T-plate.According to the Schatzker classification,we use corresponding methods in bone graft.The two groups with operation time,complication,bone healing period,height lost were compared during the 6～12 months.we use Lysholm evaluation system.[Result]Among all 105 cases,there are 74 cases accepted bone grafted.The patients were followed up 6 months to 4 years,with an average of 27.6 months.Compared with group B,group A has a short operation time,more blood loss,a shorter healing time of suture.There was no significant difference in bone healing period,height loss during the 6～12 months and Lysholm evaluating.Complication of group A was mainly in donor site,11 cases have pain in donor site,1 case has a fracture of ilium.In group B,complication were mainly in recept site,8 cases have wound effusion,3 cases have delayed wound healing.[Conclusion]Bone graft is one of the most important step in treating tibial plateau fracture,mastering its application and methods is crucial to the prognosis.Allograft and autograft have their own characters,allograft is an advertising method.