One hundred and twenty patients had an allograft reconstruction of the
femur, tibia, or humerus. Of a total of 183 allograft-host junctions,
eight-three were fixed with a plate; ninety-eight, with an intramedullary
rod; and two, with screws alone. There was no significant difference
between the rate of union after fixation with a plate and that after
intramedullary fixation (p = 1.00). However, fixation with a plate was
associated with a higher rate of fracture of the allograft (p < 0.0001).
Some problem related to the internal fixation of the allograft was
identified at eighteen of the twenty junctions that did not heal. There was
a significant association (p < 0.001) between a problem in the
achievement of stable fixation and the development of a non-union at the
allograft-host junction.