Abstract
BACKGROUND: The severe long bone defects usually follow high-energy trauma and are often associated with a signicant soft-tissue injury. The goal of management of these open long bone defects is to provide stable xation with maintenance of limb length and soft-tissue coverage. Thus, we aimed to compare the different methods in the treatment of patients with post-traumatic long bone defects, based on the long-term functional and selfevaluation results. METHODS: We retrospectively reviewed data on patients with post-traumatic long bone defects of the lower extremities from August 2018 to December 2020. The patients are divided into three groups according to the surgical method used to treat the defects (group 1, free vascularized bular transfer; group 2, distraction osteogenesis; group 3, the induced membrane technique). Data including the complication rates, entire treatment period, long-term visual analog scale scores, and Sickness Impact Prole (SIP) scores during follow-up were recorded. RESULTS: A total of 300 patients were included, with 105, 125, and 70 patients in groups 1, 2, and 3, respectively. The major complication rates were 22.6%, 25.8%, and 26.6% for the groups (P > 0.05), respectively. The mean treatment durations for bony defects, from surgery to non-protected weightbearing, were 65.1, 46.5, and 56.6 weeks for each group, respectively. At 2 years postoperatively, the average SIP scores for each group were 10.5, 11.7, and 11.5, respectively (P > 0.05). CONCLUSION: Patients who sustained long bone defects can be advised that either one of these three methods which typically results in long-term outcomes equivalent to others. Level of evidence: retrospective study.
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