Allograft reconstruction of olecranon after traumatic bone loss: a case report
Despite 2.2 million bone allografts conducted annually, their complication rate remains high, with recipients incurring infection, fracture, instability, and failure to incorporate. Nonunion rates in massive bone allografts—a bone segment ≥5 cm in length that also contains the total circumference of...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-05-01
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| Series: | JSES Reviews, Reports, and Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666639122000062 |
| _version_ | 1818160251447279616 |
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| author | Mahala F. Walker, BS Srinath Kamineni, MD |
| author_facet | Mahala F. Walker, BS Srinath Kamineni, MD |
| author_sort | Mahala F. Walker, BS |
| collection | DOAJ |
| description | Despite 2.2 million bone allografts conducted annually, their complication rate remains high, with recipients incurring infection, fracture, instability, and failure to incorporate. Nonunion rates in massive bone allografts—a bone segment ≥5 cm in length that also contains the total circumference of replaced bone—have been documented as high as 50%. However, if early complication can be avoided, a 75% success rate at 20 years postoperatively has been reported. Nonmassive allografts may yield decreased nonunion rates, as massive bone allografts must overcome a greater metaphyseal to diaphyseal incorporation rate and osteoconduction may not ensue beyond the bone periphery. The patient in this case is a 23-year-old male demonstrating absent bone in the right olecranon process of the ulna without attachment of the triceps brachii after a motorbike accident. The patient underwent olecranon allograft reconstruction with triceps brachii tendon reattachment. Four and a half years after allograft reconstruction of the right olecranon, the patient presents with minimal symptoms. However, he reports occasional aching at the site of injury. His current active arc of sagittal motion was 20°-130°, and pronation-supination was 70°-80°. His triceps strength was 4/5 Medical Research Council grade. Radiographic evaluation revealed a well-incorporated graft with a recontoured olecranon tip. Overall, this report demonstrates that operations involving a nonmassive allograft about the olecranon process may display minimal side effects in comparison to massive allografts, specifically regarding nonunion. Furthermore, this operation allows for improved range of motion after bone loss, allowing the patient to partake in activities of daily living. |
| first_indexed | 2024-12-11T15:58:54Z |
| format | Article |
| id | doaj.art-76c5e4f2b8a6479192bb174ae508d932 |
| institution | Directory Open Access Journal |
| issn | 2666-6391 |
| language | English |
| last_indexed | 2024-12-11T15:58:54Z |
| publishDate | 2022-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES Reviews, Reports, and Techniques |
| spelling | doaj.art-76c5e4f2b8a6479192bb174ae508d9322022-12-22T00:59:21ZengElsevierJSES Reviews, Reports, and Techniques2666-63912022-05-0122250253Allograft reconstruction of olecranon after traumatic bone loss: a case reportMahala F. Walker, BS0Srinath Kamineni, MD1University of Kentucky College of Medicine, Lexington, KY, USADepartment of Orthopedic Surgery, Elbow Shoulder Research Center, University of Kentucky College of Medicine, Lexington, KY, USA; Corresponding author: Srinath Kamineni, MD, Department of Orthopaedic Surgery, University of Kentucky, 740 S. Limestone, Lexington, KY 40536, USA.Despite 2.2 million bone allografts conducted annually, their complication rate remains high, with recipients incurring infection, fracture, instability, and failure to incorporate. Nonunion rates in massive bone allografts—a bone segment ≥5 cm in length that also contains the total circumference of replaced bone—have been documented as high as 50%. However, if early complication can be avoided, a 75% success rate at 20 years postoperatively has been reported. Nonmassive allografts may yield decreased nonunion rates, as massive bone allografts must overcome a greater metaphyseal to diaphyseal incorporation rate and osteoconduction may not ensue beyond the bone periphery. The patient in this case is a 23-year-old male demonstrating absent bone in the right olecranon process of the ulna without attachment of the triceps brachii after a motorbike accident. The patient underwent olecranon allograft reconstruction with triceps brachii tendon reattachment. Four and a half years after allograft reconstruction of the right olecranon, the patient presents with minimal symptoms. However, he reports occasional aching at the site of injury. His current active arc of sagittal motion was 20°-130°, and pronation-supination was 70°-80°. His triceps strength was 4/5 Medical Research Council grade. Radiographic evaluation revealed a well-incorporated graft with a recontoured olecranon tip. Overall, this report demonstrates that operations involving a nonmassive allograft about the olecranon process may display minimal side effects in comparison to massive allografts, specifically regarding nonunion. Furthermore, this operation allows for improved range of motion after bone loss, allowing the patient to partake in activities of daily living.http://www.sciencedirect.com/science/article/pii/S2666639122000062OlecranonAllograftBone extensionUlnaTricepsNonunion |
| spellingShingle | Mahala F. Walker, BS Srinath Kamineni, MD Allograft reconstruction of olecranon after traumatic bone loss: a case report JSES Reviews, Reports, and Techniques Olecranon Allograft Bone extension Ulna Triceps Nonunion |
| title | Allograft reconstruction of olecranon after traumatic bone loss: a case report |
| title_full | Allograft reconstruction of olecranon after traumatic bone loss: a case report |
| title_fullStr | Allograft reconstruction of olecranon after traumatic bone loss: a case report |
| title_full_unstemmed | Allograft reconstruction of olecranon after traumatic bone loss: a case report |
| title_short | Allograft reconstruction of olecranon after traumatic bone loss: a case report |
| title_sort | allograft reconstruction of olecranon after traumatic bone loss a case report |
| topic | Olecranon Allograft Bone extension Ulna Triceps Nonunion |
| url | http://www.sciencedirect.com/science/article/pii/S2666639122000062 |
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