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The Journal of Bone and Joint Surgery, Vol 72, Issue 6 825-833, Copyright © 1990 by Journal of Bone and Joint Surgery, Inc
Fractures of allografts. Frequency, treatment, and end-results
BH Berrey, CF Lord, MC Gebhardt and HJ Mankin
Orthopaedic Oncology Unit, Massachusetts General Hospital Cancer Center, Boston 02114.
One of the major complications of implantation of a massive frozen
cadaveric allograft in the treatment of a tumor is fracture of the
allograft. To determine the incidence, risk factors, appropriate
management, and results of treatment of this complication, the records of
the Orthopaedic Oncology Unit of the Massachusetts General Hospital were
reviewed. Forty-three patients were identified in whom a tumor had been
treated with an allograft that had subsequently fractured. The over-all
incidence of fracture was almost 16 per cent. When the several risk factors
(age and sex of the patient, stage and site of the lesion, and so on) for
the forty-three patients who had a fracture were compared with those for
the rest of the series, the only correlation was the incidence of non-union
at the site of the host-donor junction, which was significantly higher in
the patients who had a fracture. The mean time to fracture was 28.6 months
after the operation. Three types of fractures occurred: Type I (two
patients), rapid dissolution of the graft; Type II (twenty-two patients),
fracture of the shaft, which was observed more frequently in male patients
and which occurred a mean of 27.6 months after the operation; and Type III
(nineteen patients), fragmentation of the joint, which usually occurred
later (a mean of 31.6 months postoperatively) and was found more frequently
in female patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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