Shortening/re-lengthening and nailing versus bone transport for the treatment of segmental femoral bone defects

Abstract

Segmental femoral bone defects are a severe challenge for orthopedic trauma surgeons. The objective of this study was to compare the efficacy of the shortening/re-lengthening and nailing (SRN) technique with the traditional bone transport (BT) technique in treating patients with such defects. A retrospective study was conducted involving 46 patients with segmental femoral bone defects, with 21 cases treated using the SRN technique (SRN group) and 25 cases managed with the traditional BT technique (BT group). The mean length of the bone defect was 5.8 ± 1.1 cm in the SRN group and 6.1 ± 1.6 cm in the BT group. Various parameters including time in frame, external fixation index, self-rating anxiety scale (SAS) scores, bone healing scores, limb function scores, and complications were recorded. The mean time in frame for the SRN group was 3.7 ± 1.4 months, significantly shorter than the 9.4 ± 3.7 months observed in the BT group (p < 0.05). Furthermore, the mean external fixation index for the SRN group was 0.62 ± 0.12 months/cm, significantly lower than the 1.50 ± 0.19 months/cm observed in the BT group (p < 0.05). There were no significant differences in bone healing scores between the SRN and BT groups (p = 0.237). The SAS scores and incidence of complications were significantly lower in the SRN group compared to the BT group (p < 0.05). Overall, the SRN technique demonstrated superior clinical efficacy compared to the traditional BT technique for the management of segmental femoral bone defects, with shorter time in frame, lower external fixation index, and reduced complications. Therefore, the SRN technique may be considered an optimal choice for treating patients with such conditions.