Retraction of transporting bone segment during Ilizarov bone transport

BMC Musculoskeletal Disorders

Zongnan Wang¹  Yunhong Ma²  Zhenzhong Sun²  Yongjun Rui²  Xiaofei Han²  Yongwei Wu²  Sanjun Gu²  Qudong Yin² 

[1] Department of Orthopaedics, Shuyang People’s Hospital, 223000, Suqian, Jiangsu, China;Department of Orthopaedics, Wuxi No. 9 People’s Hospital Affiliated to Soochow University, No. 999 Liangxi Road, 214062, Wuxi, Jiangsu, China;

关键词: Callus distraction;    Bone transport;    Retraction of transporting bone segment;    Force;   

DOI  :  10.1186/s12891-020-03702-7

来源: Springer

【 摘 要 】

BackgroundRetraction of transporting bone segment (TBS) may occur when the fixator of the TBS is removed prior to full consolidation of the distracted callus, which has adverse effect on the healing of the docking site. However, there are few reports on the retraction of TBS. The purpose of this study is to analyze the causes and risk factors of the retraction of TBS.MethodsThe clinical data of 37 cases with tibial bone defect treated by Ilizarov bone transport were analyzed retrospectively, in whom the TBS fixator was removed prior to full consolidation of the distracted callus and union of the docking site. Bivariate correlation was used to analyze relationship between the retraction distance of TBS and potential risk factors including age, gender, course, length of bone defect, number of operations, size of TBS, transport distance, timing and time interval of removal of TBS fixator. Risk factors with significant level were further identified using multivariate linear regression.ResultsBivariate correlation showed that the timing of removal was negatively correlated with the retraction distance, and the time interval and transport distance were positively correlated with the retraction distance(p < 0.05), the age, gender, course, length of bone defect, size of TBS and number of operations were not correlated with the retraction distance(p > 0.05). Multivariate linear regression of the 3 risk factors showed that the timing of removal and time interval were the main risk factors affecting the retraction distance (p < 0.05), but the transport distance was not (p > 0.05).ConclusionThe traction forces of TBS endured from the soft tissues and the unconsolidated distracted callus have elastic properties, which can make retraction of TBS. The timing of removal and time interval are the main risk factors of the retraction of TBS. In the case of early removal, another external fixation or quickly converted to internal fixation should be performed to avoid the adverse effect of more retraction.

【 授权许可】

CC BY