Treatment of upper limb bone defects with autogenous cancellous bone graft wrapped by femoral fascia

Abstract

Objective To explore the feasibility and effect of autogenous cancellous bone graft wrapped by femoral fascia in the treatment of upper limb bone defects. Methods From June 2011 to December 2016, 12 patients with upper limb bone defects were treated with femoral fascia wrapping autogenous cancellous bone graft and internal fixation. Bone defect site: 3 cases in humerus, 5 cases in radius, and 4 cases in ulna. The length of bone defects ranged from 2.5 to 6.0 cm, with an average of 4.0 cm. Results Delayed wound healing occurred in 1 case and complications occurred in 2 cases. All the patients were follow-up for 12 to 36 months with an average of 19 months. Bone union occurred in all the patients. The clinical healing time ranged from 2.5 to 4.0 months, with an average of 2.9 months. No delayed union or nonunion occurred. The healing rate was 100%. There were no deep infection, internal fixation fracture and re-fracture in the transplantation area. At the last follow-up, limb function recovery was evaluated by DASH upper limb function questionnaire. The results were rated as excellent in 6 cases, good in 5 cases and fair in 1 case. Conclusion Femoral fascia has abundant sources and is convenient for harvesting. Femoral fascia wrapping autogenous cancellous bone graft for the treatment of upper limb bone defects is effective for small and large segmental defects. It has the advantages of simple operation, low cost, fast bone healing, high healing rate and satisfactory functional recovery. Key words: Upper extremity; Bone transplantation; Bone defects; Cancellous bone; Femoral fascia