Segmental Bone Defect Treated With the Induced Membrane Technique

Konda, Sanjit R.; Gage, Mark J.; Fisher, Nina; Egol, Kenneth A.

doi:10.1097/bot.0000000000000899

Cited by 21 publications

(31 citation statements)

References 10 publications

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“…Therefore, the longer the fixation is, the more complications occur. 3 At the present, the EFI of adult external fixation is used to measure the fixation time. The EFI of the classic tibia Ilizarov reconstruction is 48 days/cm to 75 days/cm.…”

Section: Discussionmentioning

confidence: 99%

Treatment of segmental tibial defects by bone transport with circular external fixation and a locking plate

Ren

et al. 2020

J Int Med Res

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Objective To evaluate the effectiveness of bone transport involving circular external fixation and locking plate application for the treatment of segmental tibial defects. Methods A retrospective review of 12 patients with segmental tibial defects who underwent bone transport with circular external fixation and locking plate application. We evaluated external fixation time, external fixation index, time to achieve union, and complications. Clinical results were assessed using the Association for the Study and Application of the Methods of Ilizarov (ASAMI) score. Generic health-related outcome was assessed using the 36-Item Short-Form Health Survey questionnaire (SF-36). Results The mean follow-up was 25.8 months, and the mean defect size was 6.7 cm. All of the patients achieved union at the distraction callus and docking site. The average external fixation time was 299.5 days. The mean external fixation index was 16.5 days/cm, and the mean healing index was 44.9 days/cm. The functional outcomes were excellent in eight cases and good in four. The average SF-36 score was 92. Conclusion Bone transport with external fixation and locking plate application may be a promising method for the treatment of segmental tibial defects.

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Section: Discussionmentioning

confidence: 99%

Treatment of segmental tibial defects by bone transport with circular external fixation and a locking plate

Ren

et al. 2020

J Int Med Res

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“…Large posttraumatic bone defects of the tibia combined with soft tissue defects are a common clinical problem. Currently, the treatment methods mainly include bone transport, the Masquelet technique, and free vascularised bone transfer [1][2][3][4][5][6][7][8][9]. For decades, bone transport has become recognised as optimal for the management of large posttraumatic tibial and soft tissue defects because of the complete eradication of infection, and powerful capacity for osteogenesis.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of massive tibial bone and soft-tissue defects by trifocal bone transport combined with soft-tissue transport: experience from 31 cases

Fan

et al. 2020

Preprint

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Background The study was designed to investigate the safety and efficacy of trifocal bone transport (TFT) and soft-tissue transport with the Ilizarov technique for large posttraumatic tibial bone and soft tissue defects. Methods We retrospectively reviewed 31 patients with massive posttraumatic tibial bone and soft tissue defects from May 2009 to May 2016. All of the eligible patients were managed by TFT and soft-tissue transport. The median age was 33.4 years (range, 2-58 years). The mean defect of bone was 11.87cm ± 2.78cm (range, 8.2-18.2cm) after radical resection performed by TFT. The soft tissue defects ranged from 7cm x 8cm to 24cm x 12cm. The observed results included bone union time, wound close time and true complications. The Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system was used to assess bone and functional results and postoperative complications were evaluated by Paley classification. Results The mean duration of follow-up after frame removal was 32 months (range, 12-96 months). All cases achieved complete union in both the elongation sites and the docking sites, and eradication of infection. The mean bone transport time was 94.04 ± 23.33 days (range, 63.7-147 days). The mean external fixation time was 22.74 ± 6.82 months (range, 14-37 months), and the mean external fixation index (EFI) was 1.91 ± 0.3 months/cm (range, 1.2–2.5 months/cm). The bone results were excellent in 6 patients, good in 14 patients, fair in 8 patients and poor in 3 patients. The functional results were excellent in 8 patients, good in 15 patients, fair in 5 patients and poor in 3 patients. Conclusion The TFT in concert with soft-tissue transport technique can be used successfully to manage large tibial bone and soft-tissue defects. Soft-tissue transport can offer a feasible method for the defects with good soft tissue coverage on the bone ends. However, imprecision in the series results precludes a definitive conclusion, and comparative study is needed to assess whether soft-tissue transport is more effective than flap transfer for such soft-tissue defect.

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“…Methods for treating massive bone defects include bone transport, Masquelet technique and bone grafts with or without vascular pedicle. Each method has its advantages and disadvantages [2–6]. The Ilizarov technique is currently the gold standard treatment for large segmental defects as it does not require large amounts of soft tissue and autologous bone grafts.…”

Section: Introductionmentioning

confidence: 99%

Extreme bone lengthening by bone transport with a unifocal tibial corticotomy: a case report

Wen

Yang

Xu³

2019

BMC Musculoskelet Disord

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BackgroundBone transport is used for the treatment of extensive limb bone defects. The application of ring or unilateral external fixators combined with single or double corticotomy are well documented; however, there are few cases adopting a single corticotomy to repair bone defects > 24 cm.Case presentationThe present case study describes an 18-year-old male, who was involved in a traffic accident and was diagnosed with open fracture of the right tibia. The patient received emergency surgery in a local hospital and was transferred to The Second People’s Hospital of Yunnan for further treatment 3 months later. The patient was diagnosed with fracture nonunion and infection following admission. Complete debridement was performed three times to control the infection. The infection was resolved after 26 days and the 24.5 cm massive tibia defect remained the biggest challenge. The bone transport technique involving a unilateral external fixator and single corticotomy was employed to treat the bone defect. Docking site union was achieved and bone consolidation was complete 40 months after corticotomy. The external fixator was subsequently removed. The bone healing index was 1.6 months/cm. The Association for the Study and Application of the Method of Ilizarov criteria (ASAMI) revealed a good functional and bone repair result. Similarly, Knee Society Score (KSS) yielded good result and the The Lower Extremity Functional Scale (LEFS) was 65. A total of 45 months after injury, the patient was able to walk painlessly without ambulatory assistive devices and resumed daily activities successfully. Eighteen months after the bone and soft tissue wound have healed, the SF-36 score was 86, and the LEFS was 70.ConclusionTo the best of the authors’ knowledge, the present study described the longest bone defect repair performed using bone transport with single level corticotomy.

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Segmental Bone Defect Treated With the Induced Membrane Technique

Abstract: The Masquelet technique is a generally reliable method for treating large segmental bone defects. In addition, this relatively simple technique is suitable for both infected and noninfected cases.

Cited by 21 publications

References 10 publications

Treatment of segmental tibial defects by bone transport with circular external fixation and a locking plate

Treatment of segmental tibial defects by bone transport with circular external fixation and a locking plate

Reconstruction of massive tibial bone and soft-tissue defects by trifocal bone transport combined with soft-tissue transport: experience from 31 cases

Extreme bone lengthening by bone transport with a unifocal tibial corticotomy: a case report

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