[Massive frozen allografts for skeletal reconstruction: styles and affecting factors of bone union]

To investigate the styles and affecting factors of bone union after massive frozen allografting for skeletal reconstruction owing to excision of bone tumor.

From 1992 to 1999, 85 patients suffering from bone malignant tumor were given the excision of large bone segment and treated with allografting in different methods of operation: large bone allografts with condylar articular surface in 16 cases, osteoarticular allografts in 57 cases, bone allografts in combination with prosthetic replacement of hip in 9 cases, and prosthetic replacement of knee in 3 cases. The average follow-up was 2 years and 9 months. The union time and styles of host-donor junction were determined by X-ray characters, and the results of operations were assessed according to Enneking's functional evaluation system of reconstructive procedures after surgical treatment of tumors for the musculoskeletal system.

There were 4 kinds of basic bone union styles by the X-ray characters, there were no significant difference in the time span of bone union after fixation with different methods. Of the 85 fresh-frozen allografting procedures, more than 80% of the patients were treated with interlocked intramedullary nail and allograft-prosthesis combination, and the overall result was excellent and good. Sufficient blood supply was important for host-donor junction healing, but the function of immune response was uncertain.

There were different styles of bone union after massive allografting. The recommended operative methods for massive allografts are stable internal fixation, sufficient blood supply, soft tissue repair and periosteal flap coverage.