Sites of Autologous Bone Grafts in Orthopaedic Traumatology. Analysis of complications

Background: The use of autologous bone graft in orthopaedic traumatology is not uncommon. But little work, from West African subregion, has been devoted to sites used as sources of autologous bone grafts. Objective: The purpose of this study was to evaluate the evolution of these different sampling sites of autologous graft. Materials and methods: The authors report the results of a retrospective study of 84 patients operated on between 2000 and 2005 for various bone diseases requiring autologous bone graft at CHU Treichville (in Abidjan). Excluded from this study were bone grafts sourced from femoral heads harvested during arthroplasty of the hip. The series consist of 52 men and 32 women. Sites of bone autografts were iliac in 55 patients, 18 ends of the upper tibia, 7 olecranons, 3 fibulas and 1 greater trochanter of the femur. The evaluation of patients was clinical and radiographic and included the existence or not of pain, stiffness, assessment of the scar and the existence of a local deformation. Results: Outcome was satisfactory in 72 patients. 6 patients reported pain in the iliac crest. In 11 patients, the scar to the iliac crest was unsightly. Conclusion: The authors conclude that the commonly used donor sites for autologous bone grafts are safe. Keywords:autologous bone graft, pseudoarthrosis, bone reconstructionNigerian Journal of Orthopaedics and Trauma Vol. 7 (1) 2008 pp. 20-2

Result of Surgical Treatment of Pseudoarthrosis of the Patella.

Objective: To assess the surgical treatment of pseudoarthrosis of the patella in the orthopaedic and traumatology unit of the Teaching Hospital of Treichville (Abidjan- Côte d\'Ivoire). Methods: Six patients (3 males and 3 females) of 43 years average age (from 36 to 48 years old) with pseudoarthrosis of the patella were admitted in the unit. The lesions were caused by road traffic accident in one patient and domestic accidents in 5 patients. The average time before reporting to the hospital for consultation was 130 days [93- 181 days]. A pseudoarthrosis was due to failure of an initial osteosynthesis and 5 were due to late treatment subsequent to traditional bone setting. In every case, surgery was done with tension band wiring, without graft (4 cases) and associated with cancellous bone graft in two cases. All the patients were reviewed at an average time of 44 months later [range from 28 to72 months] and examined according to Bostman score. Result: No immediate and secondary post operative complication was observed. We noted 2 cases of osteopenia of the patella, a patellofemoral arthrosis in 4 cases, and a lower post operative patella in every patient with an average index of Caton- Deschamps at 0.34 cm (From 0.15 to 0.51 cm) were observed. Two malunion of fractures and an amyotrophy compared with healthy thigh were observed. The average Bostman functional score was excellent (28.83 points/30). Conclusion: Pseudoarthrosis of the patella in our centre is the consequence of traditional bone setting or late treatment. Osteosynthesis with or without graft of these lesions allow bone union despite a functional insufficiency which does not disturb the patient\'s physical activity. Keywords: patella, pseudoarthrosisNigerian Journal of Orthopaedics and Trauma Vol. 7 (1) 2008 pp. 10-1