Guided tissue regeneration with heterologous materials in primary subtalar arthrodesis: a case report

Calcaneal fractures are relatively rare and difficult to treat. Treatment options vary based on the type of fracture and the surgeon's experiences. In recent years, surgical procedures have increasingly been used due to the better long-term results. We present a case where guided tissue regener...

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Bibliographic Details
Published in:Journal of medical case reports 2016-05, Vol.10 (1), p.108-108, Article 108
Main Authors: Frangez, Igor, Kasnik, Tea, Cimerman, Matej, Smrke, Dragica Maja
Format: Article
Language:English
Subjects:
Accidental Falls
Arthrodesis
Arthrodesis - methods
Bone Regeneration
Bone Screws
Bone Transplantation - methods
Calcaneus - injuries
Calcaneus - surgery
Case Report
Collagen
Disease
Female
Fracture fixation
Fractures, Bone - surgery
Fractures, Comminuted - surgery
Guided Tissue Regeneration - methods
Humans
Innovations
Medical treatment
Methods
Middle Aged
Regeneration (Biology)
Subtalar Joint - injuries
Subtalar Joint - surgery
Transplantation, Heterologous
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Summary:Calcaneal fractures are relatively rare and difficult to treat. Treatment options vary based on the type of fracture and the surgeon's experiences. In recent years, surgical procedures have increasingly been used due to the better long-term results. We present a case where guided tissue regeneration was performed in a calcaneal fracture that needed primary subtalar arthrodesis. We used the principles of guided tissue regeneration from oral surgery to perform primary subtalar arthrodesis and minimize the risk of non-union. We used a heterologous collagen membrane, which acts as a mechanical barrier and protects the bone graft from the invasion of unwanted cells that could lead to non-union. The collagenous membrane also has osteoconductive properties and is therefore able to increase the osteoblast proliferation rate. A 62-year-old Caucasian woman sustained multiple fractures of her lower limbs and spine after a fall from a ladder. Her left calcaneus had a comminuted multifragmental fracture (Sanders type IV) with severe destruction of the cartilage of her subtalar joint and depression of the Böhler's angle. Therefore, we performed primary arthrodesis of her subtalar joint with elevation of the Böhler's angle using a 7.3 mm titanium screw, a heterologous cortico-cancellous collagenated pre-hydrated bone mix, a heterologous cancellous collagenated bone wedge, and a heterologous collagen membrane (Tecnoss®, Italy). The graft was fully incorporated 12 weeks after the procedure and a year and a half later our patient walks without limping. We present a new use of guided tissue regeneration with heterologous materials that can be used to treat extensive bone defects after bone injuries. We believe that guided tissue regeneration using heterologous materials, including a heterologous collagen membrane that presents a mechanical barrier between soft tissues and bone as well as a stimulative component that enhances bone formation, could be more often used in bone surgery.
ISSN:1752-1947
1752-1947
DOI:10.1186/s13256-016-0907-6