Bone transport combined with bone graft and internal fixation versus simple bone transport in the treatment of large bone defects of lower limbs after trauma

BMC Musculoskeletal Disorders

Yi Bo Xu¹  Kun Zhang¹  Yao Lu¹  Ming Li¹  Hua Lin¹  Cheng Ren¹  Han Zhong Xue¹  Zhong Li¹  Qiang Huang¹  Cheng Cheng Zhang¹  Teng Ma¹  Lu Liu¹  Qian Wang¹ 

[1] Department of Orthopaedic Surgery, Hong Hui hospital, Xi’an Jiaotong University College of Medicine, 710054, Xi’an, Shaanxi, China;

关键词: Bone transport;    Bone graft;    Internal fixation;    Bone defect;   

DOI  :  10.1186/s12891-022-05115-0

来源: Springer

【 摘 要 】

BackgroundBone transport has been successfully applied for the management of large segmental bone defects. However, its main shortcoming is the long-lasting consolidation period, which may cause lots of related complications. To overcome this shortcoming, we developed bone transport combined with bone graft and internal fixation technique. The purpose of this study was to compare the clinical effects of this modified technique with simple bone transport in the treatment of large segmental bone defects of lower limbs after trauma.MethodsEighty-four patients with large segmental bone defects treated in our institution from January 2014 to January 2017 were selected for retrospective study. A total of 77 cases were completely followed. Among them, 35 patients were treated by bone transport combined with bone graft and internal fixation technique (Group A), and 42 by simple bone transport technique (Group B). Patients with open injuries were classified according to Gustilo-Anderson (GA) classification. The general data of Group A and B were compared. The time in external fixator, total cure time and operation times of two groups were recorded. Ennecking score was used to evaluate the recovery of limb functions while self-rating anxiety scale (SAS) for the postoperative anxiety evaluation. In addition, the total complication incidence was compared between Group A and B.ResultsThere was no significant difference in demographic data between Group A and B (p > 0.05). The time in external fixator of Group A and B was (4.8 ± 1.6) and (18.2 ± 3.9) months, respectively (p < 0.05). The total cure time was (17.6 ± 2.2) and (20.4 ± 2.8) months in Group A and B (p < 0.05). The number of operations in Group A and B was (4.9 ± 1.2) and (4.8 ± 1.0) (p > 0.05). Ennecking score of Group A and B was 84.7 and 75.7% (p < 0.05). SAS score and total complication incidence in Group A were significantly lower than those in Group B (p < 0.05).ConclusionsThe clinical effects of bone transport combined with bone graft and internal fixation technique were better than that of simple bone transport technique, including shorter time in external fixator, shorter total cure time, lower anxiety score and better limb functions.

【 授权许可】

CC BY