Comparison of 39 post-traumatic tibia bone transports performed with and without the use of an intramedullary rod: the long-term outcomes

Abstract

Bone transport can be performed with an external fixator alone or with the monorail technique which entails the combination of a fixator and an intramedullary nail. The purpose of this study was to compare the complication rates and long-term outcomes of these methods. Two groups of patients, the external fixator (n=21) and the monorail group (n=18), were compared. The average follow-up period was 7.9±5.6 years and the mean defect length 8.3±3

Long bone reconstruction using multilevel lengthening of bone defect fragments

“…But appreciating greatly the Ilizarov non-free bone plasty for bone defect management, most authors emphasize its essential drawback, the so called "Achilles heel", i.e. a long treatment period that requires great patient's compliance and constant care by an orthopaedic surgeon [5][6][7][8]15].…”

“…A number of previous experiments had also shown the importance of blood supply for bone regeneration and osteogenic potential of bone plasty but the conditions of experiments were different [16,17]. As for clinical situations, some surgeons use bone transport over intramedullary nail to avoid wearing an external fixator for a long time during defect repair but the combination cannot accelerate distraction osteogenesis [8,9,15].…”

“…The technique of the Ilizarov bone transport following osteotomy of a defect fragment has been used by orthopaedic surgeons worldwide, and its merits are well known [2][3][4][5][6][7]. Nevertheless, despite the high rehabilitation effect of the Ilizarov non-free bone plasty, a number of authors emphasize that it requires several stages and takes a long time in cases of extensive bone defects [5][6][7][8]. The surgeons of the Russian Ilizarov Scientific Center proposed technologies of distraction osteosynthesis for bone plasty through several distraction areas in an affected segment in order to cover an extensive defect at a single stage by growing bone tissue that structurally remodels during a shorter time of transosseous osteosynthesis [10,11].…”

Kallusaugmentation mit konzentriertem Beckenkammaspirat

“…Bei vergleichbaren Indikationen (posttraumatisch/Osteomyelitis) wurden in der Literatur im Vergleich zu idiopathischen Verlänge-rungen maximale Heilungsindizes von bis zu 142 Tagen/cm und Fixationszeiten im Transportfixateur von bis zu 54 Monaten beschrieben. Die durchschnittlichen Heilungsindizes wurden im Mittel mit über 50 Tagen/cm angegeben [23,25,29,32,35]. Der durchschnittliche Heilungsindex unserer vorläufigen Ergebnisse war mit 36 Tagen/cm deutlich niedriger.…”

Tratamiento de defectos masivos de tibia. Técnica de transporte óseo con fijador AO

“…Resultados: A idade média dos pacientes era de 32 anos (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32), a 6,7 cm perda óssea média (4-11), a taxa de distracção 0,58 milímetros/dia, período médio de 92 dias distracção (35-172) e o tempo médio de fi xação externa foi de 194 dias. O seguimento médio foi de 13 meses .…”