Bone transport with magnetic intramedullary nails in long bone defects

Abstract

Background This study describes the outcomes of internal bone transport with magnetic nails in five cases of traumatic segmental femoral bone defects. Methods Five patients with open fracture of the femur and diaphyseal bone loss were included between May 2018 and August 2020. The mean femoral defect was 8.7 cm (range 5.6–16.0). Intervention We used plate-assisted bone segment transport (PABST) with PRECICE magnetic nails. Results All five patients have fully consolidated. The mean consolidation time and index were 7.5 months and 0.8 mo/cm, respectively. The mean follow-up was 21.3 months. The main complications were reduced knee ROM, mild varus deformity and plate bending. Post-operative SF-36, Oxford Knee scores and ED-5Q-5L scores were also compiled for four of five patients. SF-36 and Oxford Knee scores were reported without pre-injury data for comparison. ED-5Q-5L index and VAS were compared UK population norm and were both found to be statistically insignificant (p = 0.071 and p = 0.068, respectively). Conclusion Bone transport with magnetic nails has the capacity to obtain good functional recovery in long bone defects despite variable outcome pictures. In response to variable outcome reporting in the literature, we propose a standard reporting template for future studies to facilitate more rigorous analyses.

Induced Membrane Technique Is Effective for the Management of Acute Traumatic Bone Loss in Both Diaphyseal and Metaphyseal Lower Extremity Fractures

“…Overall union was 89% in our series, similar to other studies and systematic reviews of IMT. 5,11,13,16…”

Treatment of a tibial bone defect with a motorized intramedullary bone transport nail: A case review with 32 months follow up

“…When reviewing the associated literature, we found studies where femoral defects from 4.8 to 16 cm and tibial defects of up to 12 cm were corrected [5] , [6] , [7] , [8] . Therefore, this technique seems to be a valid solution for the treatment of diaphyseal bone defects in the femur and the tibia.…”

An Update on the Intramedullary Implant in Limb Lengthening: A Quinquennial Review Part 2: Extending Surgical Indications and Further Innovation

“…Some of the major disadvantages with this technique include the prolonged time in the external fixator, pin site issues, joint stiffness and general delay in rehabilitation. With the internal lengthening nails alternative procedures have been introduced, mainly plate assisted bone segment transport techniques (PABST) [26][27][28][29] and the use of a bone transport nail [30] .…”

“…They describe the technique in depth relating to the first patient and early outcomes seen in an additional two. The additional medial plate prevents varus deformity, which can result in bending of an isolated lateral plate [28] . Recommendations included over-reaming of the transport segment with insertion of the smallest diameter lengthening nail, in their cases an 8.5 mm Precice nail.…”