Abstract
AIM: To study bone healing and infection incidence using Allograft bone in acute comminuted fractures in elderly.
METHOD: 21 cases of comminuted fractures of distal femur and proximal tibia requiring bone grafting at primary fixation between 1999 and 2004 were included. Out of 19 cases of proximal tibial fractures, 7 were Schatzker type III, 6 were type IV and 6 were type V. Mean patient’s age was 74 years. Rigid internal fixation with sterilized human Cadaveric allograft was used to fill the defect. No additional auto-bone grafting was done. All cases had 24 hours postop IV antibiotics and were followed up clinically and radiologically until the end point of union or nonunion.
OUTCOME: 20/21 cases had fracture union within expected duration. 83 years old patient with Supracon-dylar fracture of femur with DCS fixation, failed to unite at 12 months post op and required revision surgery.
20/21 cases had no superficial or deep infection. 62 years old patient with Schatzker IV tibial plateau fracture had deep infection requiring wound debridement and removal of implant which revealed unabsorbed allograft at one year post op which also cleared the infection.
CONCLUSION: Allograft bone graft can be a safe bone substitute for promoting bone healing in elderly patients in acute fracture management.
We recommend using allograft bone in elderly patients to reduce morbidity by avoiding one more surgery of obtaining bone graft.
Allograft bone in elderly used with internal fixation also provides a reasonable structural support along with it osteoinductive properties.
Correspondence should be addressed to Mr Bimal Singh, BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE
