Uso de ortobiológicos y aloinjerto en el tratamiento de pseudoartrosis con pérdida ósea diafisaria femoral

Abstract

Pseudoarthrosis is a complication that poses a challenge for the orthopedist. If is associated with bone loss, a salvage surgery is indicated. There is no protocol for treatment for pseudoarthrosis with a «critical defect». The induced membrane technique, distraction osteogenesis, among others, has been described; however, the long time and elevated costs involved have opened a new landscape on the research of new protocols. The «diamond concept» which is not only based of improving biomechanics, but also introduces biological stimulation as a pillar of treatment, was recently introduced. We present the case of a 16-year-old female patient with a femoral shaft fracture after a traffic accident, treated initially with a centromedullar blocked nailing that progresses to pseudoarthrosis, presenting a 5 cm bone loss. Treatment consisted of removing the centromedullar blocked nail, resection of the nonviable bone segment, osteosynthesis with another centromedullar blocked nailing, placement a 7 cm diaphyseal allograft, platelet-rich plasma (PRP), matrix allograft, and bone chips, thus achieving radiographic and clinical consolidation; restoring limb function in a shorter time, considering the PRP as the main orthobiological element in this case.