Structural Bone Allograft in Pediatric Foot Surgery
Philip D. Nowicki, MD, Chester M. Tylkowski, MD, Henry J. Iwinski, MD, Vishwas Talwalkar, MD, Janet L. Walker, MD, and Todd A. Milbrandt, MD, MS
Dr. Nowicki is Fellow, Pediatric Orthopaedics, Department of Orthopaedic Surgery, University of Michigan Health System, Ann Arbor, Michigan.
Dr. Tylkowski is Chief of Staff, Dr. Iwinski is Assistant Chief of Staff, and Drs. Talkwalkar, Walker, and Milbrandt are Attending Physicians, Shriners Hospital for Children, Lexington, Kentucky.
Structural bone allografts are used in a variety of surgical procedures, but only a few investigators have examined their use and associated complications in the pediatric population specifically. In a retrospective review of pediatric foot procedures, we sought to determine types and rates of complications associated with structural bone allografts as well as time to incorporation of these allografts. Minimum follow-up was 12 months. Eighteen patients with 31 structural allografts were reviewed. The total complication rate was 7.1%, and the allograft incorporation rate was 90% (mean time after surgery, 9 months). Mean follow-up was 22 months. There were no pseudarthroses, nonunions, or fractures at the bone-graft sites. Structural bone allografts can be safely used in foot procedures in pediatric neuromuscular patients without major risk for complications, and their use can reduce autograft-harvest morbidity in pediatric patients with neuromuscular conditions.