Subscribe to RSS
DOI: 10.1055/s-0038-1631878
Clinical Efficacy of Bone Reconstruction Surgery with Frozen Cortical Bone Allografts for Nonunion of Radial and Ulnar Fractures in Toy Breed Dogs
Publication History
08 March 2017
19 December 2017
Publication Date:
23 April 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035023/201803/lookinside/thumbnails/10-1055-s-0038-1631878_170032-1.jpg)
Abstract
Objective To evaluate the effectiveness of frozen cortical bone allografts (FCBA) in the treatment of severe radial and ulnar atrophic nonunion fractures.
Animals Toy breed dogs with nonunion of radial and ulnar fractures (n = 15).
Methods Severe atrophic nonunion fractures were treated with FCBA (eight infected and seven non-infected fractures). Radiographs obtained immediately after surgery, and 1, 2, 3, 6 and 12 months later were evaluated and scored for the periosteal reaction at the bone regeneration sites, the healing process in the bone connection areas at both the proximal and distal sites, and the bone remodelling process within the allografts.
Results Improvements in the fracture-healing process and weight-bearing function were observed in all cases. Radiographic scores at the bone connection areas and within the allograft improved significantly over time (p < 0.05). There were not any significant differences in radiographic scores between the infected and non-infected groups.
Clinical Significance Bone reconstruction with FCBA is effective in the treatment of radial and ulnar nonunion fractures associated with large bone defects, regardless of the infection status of the surgical site.
Keywords
frozen cortical bone allograft - radius - nonunion fracture - radiographic analysis - bone infection - surgical treatmentAuthor contributions
Shuntaro Munakata, Yasushi Hara and Nobuo Kanno contributed to conception of study, study design, acquisition of data and data analysis and interpretation. Daichi Katori, Yasuji Harada and Norihiro Muroi contributed to acquisition of data and data analysis and interpretation. Shinya Yamaguchi and Hiroyuki Akagi contributed to study design, acquisition of data and data analysis and interpretation. Kei Hayashi contributed to data analysis and interpretation. Yukari Nagahiro contributed to conception of study, study design and acquisition of data. All authors drafted and revised and approved the submitted manuscript.
-
References
- 1 Piermattei DL, Flo GL, DeCamp CE. Delayed union and nonunion. In: Brinker, Piermattei, and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. 4th ed. Philadelphia, PA: Saunders, Elsevier; 2006: 168-176
- 2 Welch JA, Boudrieau RJ, DéJardin LM, Spodnick GJ. The intraosseous blood supply of the canine radius: implications for healing of distal fractures in small dogs. Vet Surg 1997; 26 (01) 57-61
- 3 Weber BG, Čech O. Pseudoarthrosis: Pathology, Biomechanics, Therapy, Results. Berne, Switzerland: Hans Huber Medical Publisher; 1976
- 4 Atilola M, Sumner-Smith G. Nonunion fractures in dogs. J Vet Orthop 1984; 3: 21-24
- 5 Harada Y, Itoi T, Wakitani S. , et al. Effect of Escherichia coli-produced recombinant human bone morphogenetic protein 2 on the regeneration of canine segmental ulnar defects. J Bone Miner Metab 2012; 30 (04) 388-399
- 6 Sinibaldi KR. Evaluation of full cortical allografts in 25 dogs. J Am Vet Med Assoc 1989; 194 (11) 1570-1577
- 7 Campoy L, Read MR. The thoracic limb. In: Campoy L, Read MR. , eds. Small Animal Regional Anesthesia and Analgesia. Hoboken, NJ: Wiley-Blackwell; 2013
- 8 Hunt GB. Local or subdermal plexus flaps. In: Tobias KM, Johnson SA. , eds. Vol. 2. Veterinary Surgery: Small Animal. St Louis, MO: Saunders, Elsevier; 2012: 1243
- 9 Ochi H, Hara Y, Asou Y. , et al. Effects of long-term administration of carprofen on healing of a tibial osteotomy in dogs. Am J Vet Res 2011; 72 (05) 634-641
- 10 Fernandes MB, Guimarães JA, Casado PL. , et al. The effect of bone allografts combined with bone marrow stromal cells on the healing of segmental bone defects in a sheep model. BMC Vet Res 2014; 10: 36
- 11 LaRue SM, Withrow SJ, Powers BE. , et al. Limb-sparing treatment for osteosarcoma in dogs. J Am Vet Med Assoc 1989; 195 (12) 1734-1744
- 12 Liptak JM, Dernell WS, Ehrhart N, Lafferty MH, Monteith GJ, Withrow SJ. Cortical allograft and endoprosthesis for limb-sparing surgery in dogs with distal radial osteosarcoma: a prospective clinical comparison of two different limb-sparing techniques. Vet Surg 2006; 35 (06) 518-533
- 13 Chmell MJ, McAndrew MP, Thomas R, Schwartz HS. Structural allografts for reconstruction of lower extremity open fractures with 10 centimeters or more of acute segmental defects. J Orthop Trauma 1995; 9 (03) 222-226
- 14 Franczuszki D, Chalman JA, Butler HC, Debowes RM, Leipold H. Postoperative effects of experimental femoral shortening in the mature dog. Vet Surg 1987; 16: 89
- 15 Harasen G. Common long bone fractures in small animal practice--part 1. Can Vet J 2003; 44 (04) 333-334
- 16 Harasen G. Common long bone fracture in small animal practice: part 2. Can Vet J 2003; 44 (06) 503-504
- 17 Field JR. Bone plate fixation: its relationship with implant induced osteoporosis. Vet Comp Orthop Traumatol 1997; 197 (10) 88-94
- 18 Khan SN, Cammisa Jr FP, Sandhu HS, Diwan AD, Girardi FP, Lane JM. The biology of bone grafting. J Am Acad Orthop Surg 2005; 13 (01) 77-86
- 19 Herndon CH, Chase SW. The fate of massive autogenous and homogenous bone grafts including articular surfaces. Surg Gynecol Obstet 1954; 98 (03) 273-290
- 20 Stevenson S, Li XQ, Martin B. The fate of cancellous and cortical bone after transplantation of fresh and frozen tissue-antigen-matched and mismatched osteochondral allografts in dogs. J Bone Joint Surg Am 1991; 73 (08) 1143-1156
- 21 Langer R, Vacanti JP. Tissue engineering. Science 1993; 260 (5110): 920-926
- 22 Akagi H, Ochi H, Kannno N. , et al. Clinical efficacy of autogenous cancellous bone and fibroblast growth factor 2 combined with frozen allografts in femoral nonunion fractures. Vet Comp Orthop Traumatol 2013; 26 (02) 123-129
- 23 Solchaga LA, Penick K, Porter JD, Goldberg VM, Caplan AI, Welter JF. FGF-2 enhances the mitotic and chondrogenic potentials of human adult bone marrow-derived mesenchymal stem cells. J Cell Physiol 2005; 203 (02) 398-409
- 24 Pri-Chen S, Pitaru S, Lokiec F, Savion N. Basic fibroblast growth factor enhances the growth and expression of the osteogenic phenotype of dexamethasone-treated human bone marrow-derived bone-like cells in culture. Bone 1998; 23 (02) 111-117
- 25 Hurley MM, Lee SK, Raisz LG, Bernecker P, Lorenzo J. Basic fibroblast growth factor induces osteoclast formation in murine bone marrow cultures. Bone 1998; 22 (04) 309-316
- 26 Zuo J, Jiang J, Dolce C, Holliday LS. Effects of basic fibroblast growth factor on osteoclasts and osteoclast-like cells. Biochem Biophys Res Commun 2004; 318 (01) 162-167
- 27 Gospodarowicz D, Ferrara N, Schweigerer L, Neufeld G. Structural characterization and biological functions of fibroblast growth factor. Endocr Rev 1987; 8 (02) 95-114
- 28 Saadeh PB, Mehrara BJ, Steinbrech DS. , et al. Mechanisms of fibroblast growth factor-2 modulation of vascular endothelial growth factor expression by osteoblastic cells. Endocrinology 2000; 141 (06) 2075-2083
- 29 Nakamura T, Hara Y, Tagawa M. , et al. Recombinant human basic fibroblast growth factor accelerates fracture healing by enhancing callus remodeling in experimental dog tibial fracture. J Bone Miner Res 1998; 13 (06) 942-949
- 30 Wang JS, Aspenberg P. Basic fibroblast growth factor increases allograft incorporation. Bone chamber study in rats. Acta Orthop Scand 1994; 65 (01) 27-31
- 31 Forell EB, Straw RC. Bone morphogenetic proteins and derived growth factors. Vet Comp Orthop Traumatol 1993; 6: 166-171
- 32 Stevenson S. Biology of bone grafts. Orthop Clin North Am 1999; 30 (04) 543-552