Olecranon bone grafting for the treatment of nonunion after distal finger replantation

Burak Sercan Ercin,Fatih Kabakas,Musa Kemal Keles,Berkan Mersa,Ismail Bulent Ozcelik

doi:10.20517/2347-9264.2020.56

Abstract

Aim: Although not very popular, the olecranon bone graft is a useful option for this type of operation due to the minimal donor morbidity and its ease of use in small bone defect reconstruction and non-union therapy. To our best knowledge, few studies have evaluated the use of the olecranon bone graft as a treatment for non-union after distal finger replantation. Our aim in this report was to present our experience of using olecranon grafts in our nonunion patients undergoing distal replantations. Methods: Between 2013 and 2019, a total of 14 patients who developed nonunion or had segmental bone defects due to the injury were included in the study. Retrospectively the results were analyzed in terms of complication and union rates. Results: The mean follow-up period was 37 months (range 8-72 months). No major complications were seen in the donor region or recipient regions. One patient developed necrosis in the nail bed and one patient had a hematoma in the donor site. The minor complications were solved without any problem. Conclusion: In conclusion, we found the olecranon bone grafting for the treatment of nonunion after distal finger replantation is a safe and convenient method. It can be preferred as the first choice for nonunions of distal finger replantations.

Highlights

The first successful finger replantation was performed by Tamai, and major advances in replantation surgery have been made since [1]
The rate of the union in distal phalanx bone fractures is quite high; nonunion sometimes occurs due to inadequate fixation, segmental bone loss, soft tissue problems, and infection[3]
Few studies have evaluated the use of the olecranon bone graft as a treatment for nonunion after distal finger replantation

Summary

Introduction

The first successful finger replantation was performed by Tamai, and major advances in replantation surgery have been made since [1]. The survival of the replanted finger is no longer a sufficient criterion for success; rather, functional recovery is considered crucial. Especially those distal to the distal interphalangeal joint, are technically difficult, but many are likely to be functionally successful[2]. Adequate vascular repair affects replant viability in the short term, but functional success is largely affected by bone fixation. Patients with nonunion often experience instability, pain, and radiological abnormalities. In those cases, a bone graft may be required

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Conclusion