Strategies for large bone defect reconstruction after trauma, infections or tumour excision: a comprehensive review of the literature

Migliorini, Filippo; La Padula, Gerardo; Torsiello, Ernesto; Spiezia, Filippo; Oliva, Francesco; Maffulli, Nicola

Abstract

Large bone defects resulting from musculoskeletal tumours, infections, or trauma are often unable to heal spontaneously. The challenge for surgeons is to avoid amputation, and provide the best functional outcomes. Allograft, vascularized fibular or iliac graft, hybrid graft, extracorporeal devitalized autograft, distraction osteogenesis, induced-membrane technique, and segmental prostheses are the most common surgical strategies to manage large bone defects. Given its optimal osteogenesis, osteoinduction, osteoconduction, and histocompatibility properties, along with the lower the risk of immunological rejection, autologous graft represents the most common used strategy for reconstruction of bone defects. However, the choice of the best surgical technique is still debated, and no consensus has been reached. The present study investigated the current reconstructive strategies for large bone defect after trauma, infections, or tumour excision, discussed advantages and disadvantages of each technique, debated available techniques and materials, and evaluated complications and new perspectives.

Citation

Migliorini, F., La Padula, G., Torsiello, E., Spiezia, F., Oliva, F., & Maffulli, N. (2021). Strategies for large bone defect reconstruction after trauma, infections or tumour excision: a comprehensive review of the literature. European Journal of Medical Research, 26(1), Article ARTN 118. https://doi.org/10.1186/s40001-021-00593-9

• Journal Article Type: Article
• Acceptance Date: Sep 20, 2021
• Publication Date: Oct 2, 2021
• Publicly Available Date: May 30, 2023
• Journal: European Journal of Medical Research
• Publisher: Springer Verlag
• Volume: 26
• Issue: 1
• Article Number: ARTN 118
• DOI: https://doi.org/10.1186/s40001-021-00593-9
• Keywords: Bone defect, Biological, Autologous, Graft
• Publisher URL: https://eurjmedres.biomedcentral.com/articles/10.1186/s40001-021-00593-9