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Sarcoma
Volume 2012 (2012), Article ID 197540, 6 pages
http://dx.doi.org/10.1155/2012/197540
Research Article

Comparison of Surface Area across the Allograft-Host Junction Site Using Conventional and Navigated Osteotomy Technique

1Department of Orthopaedic Surgery, Montefiore Medical Center, The Children’s Hospital at Montefiore, Bronx, NY 10467, USA
2The Albert Einstein College of Medicine, Bronx, NY 10461, USA
3Department of Epidemiology and Population Health, Montefiore Medical Center, Bronx, NY 10467, USA
4Department of Pediatrics, Montefiore Medical Center, The Children’s Hospital at Montefiore, Bronx, NY 10467, USA
5Rothman Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA

Received 21 July 2012; Revised 9 November 2012; Accepted 26 November 2012

Academic Editor: Hans Rechl

Copyright © 2012 Ajay Lall et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bulk allograft reconstruction plays an important role in limb-salvage surgery; however, non-union has been reported in up to 27% of cases. The purpose of this study is to quantify average surface contact areas across simulated intraoperative osteotomies using both free-hand and computer-assisted navigation techniques. Pressure-sensitive paper was positioned between two cut ends of a validated composite sawbone and compression was applied using an eight-hole large fragment dynamic compression plate. Thirty-two samples were analyzed for surface area contact to determine osteotomy congruity. Mean contact area using the free-hand osteotomy technique was equal to 0.21 square inches. Compared with a control of 0.69 square inches, average contact area was found to be 30.5% of optimal surface contact. Mean contact area using computer-assisted navigation was equal to 0.33 square inches. Compared with a control of 0.76 square inches, average contact area was found to be 43.7% of optimal surface contact. Limited contact achieved using standard techniques may play a role in the high rate of observed non-union, and an increase in contact area using computer-assisted navigation may improve rates of bone healing. The development of an oncology software package and navigation hardware may serve an important role in decreasing non-union rates in limb salvage surgery.