Tomeno B, Gerber C
Rev Chir Orthop Reparatrice Appar Mot. 1987;73(2):131-6.
An analysis has been made of the records of 23 cases of resection-reconstruction of the shafts of long bones for a variety of tumours of bone. Four were in the humerus, four in the forearm bones, five in the femur and ten in the tibia. The reconstructed bone was stabilised by an intramedullary nail in thirteen cases and by a plate or blade-plate in five cases. In five cases, the grafts were simply held by screws. The bone was reconstructed by an autograft in thirteen cases and by allograft in ten cases, four of which were combined with an autograft. Resections in the upper limb gave rise to few complications. Conversely, reconstructions in the lower limbs, particularly of the tibia, were associated with a significant number of complications because of infection and delayed union. The best fixation, when it was technically possible, was an intramedullary nail surrounded by autografts. Allografts, and the vascularised fibular graft, were very liable to secondary fatigue fracture. A combination of autograft and allograft needs to be considered if a sufficient quantity of autograft is not available.