Abstract
This study aims to provide a new method for treatment of severely comminuted fractures without bone loss using the well-known technique of bone transport. Sixteen patients suffering from severely comminuted fractures with closed soft tissue injury were prospectively treated using bone transport by Ilizarov circular fixator. There were 14 male and 2 female patients. The mean age was 36.5 years (27–45). There were 13 proximal tibial metaphyseal fractures, one tibial diaphyseal fracture and two femoral distal metaphyseal fractures. All patients had closed soft tissue. The mean length of the comminution gap was 50.3 mm (40–64). Fracture healing occurred in 15 patients. The mean healing time was 23.4 weeks (14–30). No bone stimulating procedures were needed for either the fracture or distraction site. Using the IOWA knee and ankle score for assessment of the 15 patients who completed treatment: the functional outcome for the knee was excellent in 11 patients, good in three and fair in one. The ankle score was excellent in 12 patients, good in two and fair in one. According to Paley and Maar’s, bone results were excellent in 14 patients, good in one patient and poor in the patient who had failure of the procedure. The results achieved in this work are encouraging to keep on applying this technique to treat fractures that meet the following criteria: metaphyseal, with total circumferential comminution involving more than 4 cm of the bone length.
Highlights
Bone transport for the management of traumatic bone loss is a well-known technique [1,2,3,4]
This study aims to provide a new method for treatment of severely comminuted fractures without bone loss using the well-known technique of bone transport
The results achieved in this work are encouraging to keep on applying this technique to treat fractures that meet the following criteria: metaphyseal, with total circumferential comminution involving more than 4 cm of the bone length
Summary
Bone transport for the management of traumatic bone loss is a well-known technique [1,2,3,4]. Bone loss may occur from extrusion of fragments at the time of injury or during debridement of an open fracture when devitalized segments of bone are removed. This creates a segmental defect or gap between the remaining bone ends. A severely comminuted fracture with intact soft tissue envelope, having circumferentially widely separated fragments that involve more than 2 cm of the bone length, should be considered as a fracture with ‘‘contained defect’’ or ‘‘internal bone loss.’’ Open fractures with segmental defects more than 2 cm are unlikely to heal spontaneously following bone stabilization alone. Various surgical methods have been proposed for treating such complex fractures including: internal fixation by plates and screws, intramedullary nailing and external fixation [5, 9, 10]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
