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VOLUME 15 , ISSUE 3 ( September-December, 2020 ) > List of Articles

CASE SERIES

A Novel Technique—Bone Splitting and Bone Grafting in an Hourglass-shaped Bone Following Distraction Osteogenesis

Huang S Lee, Rohaman Tasarib, Fahrudin C Hamzah, Ashraf HA Halim

Keywords : Distraction osteogenesis, Hourglass, Hypoplastic, Ilizarov

Citation Information : Lee HS, Tasarib R, Hamzah FC, Halim AH. A Novel Technique—Bone Splitting and Bone Grafting in an Hourglass-shaped Bone Following Distraction Osteogenesis. 2020; 15 (3):175-178.

DOI: 10.5005/jp-journals-10080-1509

License: CC BY-NC-SA 4.0

Published Online: 00-12-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: We describe a novel technique of bone splitting and bone grafting in managing hypoplastic or hourglass-shaped regenerated bone in distraction osteogenesis. Background: Hourglass-shaped regenerated bone is a potential complication during distraction osteogenesis which is vulnerable to fracture when loaded. Our novel technique overcomes this by increasing the diameter of new bone formation via bone splitting and bone grafting. Case description: We report three cases with hypoplastic regenerated bone following distraction osteogenesis. It was treated with bone splitting and bone grafting. Although one case was complicated with an iatrogenic transverse fracture during the surgery, all three cases achieved the goal of increasing bone diameter during the subsequent consolidation phase. Conclusion: This relatively simple and novel surgical intervention can overcome the hourglass-shaped appearance, thus preventing potential fracture. Clinical significance: We emphasise the importance of identifying hypoplastic regenerate bone before the consolidation phase of distraction osteogenesis. The novel technique described is a simple surgical intervention which can prevent potential fracture through the newly formed bone.


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  1. Borzunov D, Shastov A. Ischemic distraction regenerate: interpretation, definition, problems and solutions. Traumatol Orthop Russia 2019 March;25(1):68–76. Available from: https://www.researchgate.net/publication/333143252_Ischemic_Distraction_Regenerate_Interpretation_Definition_Problems_and_Solutions. DOI: 10.21823/2311-2905-2019-25-1-68-76.
  2. Li R, Yang L. Radiographic classification of osteogenesis during bone distraction. J Orthop Res 2006 March;24(3):339–347. Available from: https://www.researchgate.net/publication/7296555_Radiographic_classification_of_osteogenesis_during_bone_distraction. DOI: 10.1002/jor.20026.
  3. Hamada M, Sakamoto Y, Nagasao T, et al. Treatment of complications after distraction osteogenesis for brachymetatarsia of the fourth metatarsal. Plant Reconstr Surg Glob Open 2016 July;4;e817. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977145/. DOI: 10.1097/GOX.0000000000000836.
  4. Khaleel A, Pool RD. Bone transport. Curr Orthop 2001 June;5(3):229–237. Available from: https://www.researchgate.net/publication/246836597_Bone_transport. DOI: 10.1054/cuor.2001.0173.
  5. Lamm BM, Gourdine-Shaw MC. Problems, obstacles, and complications of metatarsal lengthening for the treatment of brachymetatarsia. Clin Podiatr Med Surg 2010 October;27(4):561–582. Available from: https://www.researchgate.net/publication/47383307_Problems_Obstacles_and_Complications_of_Metatarsal_Lengthening_for_the_Treatment_of_Brachymetatarsia. DOI: 10.1016/j.cpm.2010.06.006.
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