Locking versus standard plates for allograft fixation after tumor resection in children and adolescents

Purpose: This investigation was undertaken to assess the performance of locking plates in comparison to standard compression plates for allograft fixation after resection of malignant primary skeletal tumors. Methods: Using a computerized database, patients younger than 18 years who had undergone resection of malignant skeletal tumors with allograft reconstruction from January 1998 through June 2004 were identified. Demographic, oncological, surgical, and follow-up data were collected, and comparison of outcomes with regard to allograft-host junction healing between locking and standard compression plates was undertaken. Results: Thirty-nine patients meeting the inclusion criteria were identified. Homogeneity of the study group with regards to age, sex, diagnosis, adjuvant therapy, and presence of metastases allowed for evaluation of allograft-host union as a relatively independent variable. Nine patients in the locking plate group (75%) united after the index procedure at an average of 13.1 months. Fifteen patients (55.6%) with compression plates healed after the initial reconstruction at an average of 14.6 months. Complications and secondary procedures were noted. Conclusions: Results of this investigation suggest that use of locking plates for allograft-host junction fixation is associated with improved union rates and less need for additional operations when compared with standard compression plates.