A pedicled bone graft from the acromion: an anatomical investigation regarding surgical feasibility.

Détails

ID Serval
serval:BIB_6AF1F4F19447
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
A pedicled bone graft from the acromion: an anatomical investigation regarding surgical feasibility.
Périodique
Journal of Shoulder and Elbow Surgery
Auteur(s)
Moor B.K., Kohut G., Bouaicha S., Grabherr S., Gautier E., Bergmann M., Marcer N., Djonov V.
ISSN
1532-6500 (Electronic)
ISSN-L
1058-2746
Statut éditorial
Publié
Date de publication
2012
Volume
21
Numéro
5
Pages
604-611
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article
Publication Status: ppublish
Résumé
OBJECTIVE: To investigate the technical feasibility of harvesting a vascularized bone graft from the acromion pedicled on the acromial branch.
BACKGROUND: Complex fractures of the proximal humerus may result in partial or total avascular necrosis of the head fragment. Treatment of avascular necrosis of the humeral head is dependent upon the stage of disease as well as the dimension and location of necrosis. In general, the outcome is poor and complete restoration of the shoulder function is rarely attained. Contrary to osteonecrosis of carpal bones (where vascularized bone grafts have been routinely carried out for decades), reports of analogous procedures at the humeral head are anecdotal.
METHODS: Based on selective post-mortem computer-tomographic angiography of 5 and the dissection of 30 embalmed human cadaver shoulders, we describe the anatomy of the acromial branch of the thoracoacromial trunk. The main focus was the constancy of its anatomical course, its dimensions and potential use as a nutrient vessel for a pedicled bone graft from the acromion.
RESULTS: The course of the acromial branch revealed a constant topographic relationship to anatomical landmarks. Its terminal branches reliably supplied the anterior part of the acromion. The vascularized bone graft could be sufficiently mobilized to allow tension-free transfer to the humeral head as well as to the lateral two-thirds of the clavicle.
CONCLUSION: We demonstrated the feasibility of vascularized bone graft harvesting from the acromion. This technique could be a joint-preserving procedure for osteonecrosis of the humeral head or may assist in the revision of a clavicular pseudoarthrosis.
Mots-clé
Acromion/anatomy & histology, Acromion/transplantation, Aged, Aged, 80 and over, Bone Transplantation, Cadaver, Feasibility Studies, Female, Humans, Male, Middle Aged, Orthopedic Procedures/methods, Shoulder Fractures/surgery, Surgical Flaps
Pubmed
Web of science
Création de la notice
09/06/2012 19:13
Dernière modification de la notice
29/05/2018 10:55
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