Treatment of Segmental Tibial Defects Using Acute Bone Shortening Followed by Gradual Lengthening with Circular External Fixator

Rahal, Sheila Canevese; Volpi, Reinaldo dos Santos; Vulcano, Luiz Carlos

doi:10.1111/j.1439-0442.2005.00708.x

Cited by 11 publications

(18 citation statements)

References 30 publications

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“…However, postoperative complications are common, such as bone exposure and bone non- union usually along with axis deviation in long segmental bone transport, consolidation of newly formed bone is poor, delayed union or non-union can occur at the docking site, and pin track infection and screw loosening, stiffness of the knee and ankle joint foot drop can occur [5]. Many studies of the ASD technique have shown that it has obvious advantages and can significantly shorten the time of union [24,[28][29][30]. It reduces or closes the wound, effectively reduces the soft-tissue tension, and reduces the incidence of postoperative bone infection, bone exposure, osteonecrosis and soft-tissue necrosis; it is especially suitable for patients with large wounds [31][32][33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

“…3 Comparison of external fixation index between the BT and AST groups studies. Some studies believe that docking site union is the key factor that affects the whole therapeutic time, and the AS technique is more advantageous in shortening the docking site union time [24,[28][29][30]. Therefore, the bone union time of the AS group may be shorter.…”

Section: Bone Union Timementioning

confidence: 99%

See 1 more Smart Citation

Bone transport versus acute shortening for the management of infected tibial bone defects: a meta-analysis

Wen

Zhu

et al. 2020

BMC Musculoskelet Disord

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Background: The treatment for infected tibial bone defects can be a great challenge for the orthopaedic surgeon. This meta-analysis was conducted to compare the safety and efficacy between bone transport (BT) and the acute shortening technique (AST) in the treatment of infected tibial bone defects. Methods: A literature survey was conducted by searching the PubMed, Web of Science, Cochrane Library, and Embase databases together with the China National Knowledge Infrastructure (CNKI) and the Wanfang database for articles published up to 9 August 2019. The modified Newcastle-Ottawa scale (NOS) was adapted to evaluate the bias and risks in each eligible study. The data of the external fixation index (EFI), bone grafting, bone and functional results, complications, bone union time and characteristics of participants were extracted. RevMan v.5.3 was used to perform relevant statistical analyses. Standard mean difference (SMD) was used for continuous variables and relative risk (RR) for the binary variables. All of the variables included its 95% confidence interval (CI). Results: Five studies, including a total of 199 patients, were included in the study. Statistical significance was observed in the EFI (SMD = 0.

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Section: Discussionmentioning

confidence: 99%

Section: Bone Union Timementioning

confidence: 99%

Bone transport versus acute shortening for the management of infected tibial bone defects: a meta-analysis

Wen

Zhu

et al. 2020

BMC Musculoskelet Disord

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“…No statistical signi fi cances were detected in all parameters between regenerated and intact tibiae at 104 weeks. To compare (Rahal et al 2005 ) (Fig. 40.6 ).…”

Section: Dogsmentioning

confidence: 99%

Preclinical Animal Models for Segmental Bone Defect Research and Tissue Engineering

Reichert¹,

Berner²,

Saifzadeh³

et al. 2013

Regenerative Medicine

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Commonly applied therapies to achieve bone reconstruction or function are restricted to the transplantation of autografts and allografts, or the implantation of metal devices or ceramic-based implants. Bone grafts generally possess osteoconductive and osteoinductive properties. They are, however, limited in access and availability and harvest is associated with donor site morbidity, hemorrhage, risk of infection, insuf fi cient transplant integration, and graft devitalisation. As a result, recent research focuses on the development of alternative therapeutic concepts. Available literature indicates that bone regeneration has become a focus area in the fi eld of tissue engineering. Hence, a considerable number of research groups and commercial entities work on the development of tissue engineered constructs to aid bone regeneration. However, bench to bedside translations are still infrequent as the process towards approval by regulatory bodies is protracted and cost-intensive. Approval requires both comprehensive in vitro and in vivo studies necessitating the utilisation of large preclinical animal models. Consequently, to allow comparison between different studies and their outcomes, it is essential to standardize animal models, fi xation devices, surgical procedures and methods of taking measurements to produce reliable data pools as a base for further research directions. The following chapter reviews animal models of the weight-bearing lower extremity utilized in the fi eld, which include representations of fracture-healing, segmental bone defects, and fracture non-unions.

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“…[5] Many studies of the ASD technique have shown that it has obvious advantages and can significantly shorten the time of union. [24,[28][29][30] It reduces or closes the wound, effectively reduces the soft-tissue tension, and reduces the incidence of postoperative bone infection, bone exposure, osteonecrosis and soft-tissue necrosis; it is especially suitable for patients with large wounds. [31][32][33][34][35][36][37] However, according to two studies, [38,39] it may cause vascular and nerve injury and require more bone grafts and a limited shortening distance.…”

Section: Advantages and Disadvantages Of Ast And Bt From Previous Litmentioning

confidence: 99%

“…Some studies believe that docking site union is the key factor that affects the whole therapeutic time, and the AS technique is more advantageous in shortening the docking site union time. [24,[28][29][30] Therefore, the bone union time of the AS group may be shorter. However, bone union may be affected by many factors, such as the severity of the original injury and infection, the length of bone defect and other factors.…”

Section: Outcome Analysis Efimentioning

confidence: 99%

Bone transport versus acute shortening for the management of infected tibial bone defects: A meta-analysis

Wen¹,

Zhu²,

Li³

et al. 2020

Preprint

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Background:The treatment for infected tibial bone defects can be a great challenge for the orthopaedic surgeon. This meta-analysis was conducted to compare the efficacy and safety between bone transport (BT) and the acute shortening technique (AST) in the treatment of infected tibial bone defects. Methods: A literature survey was conducted by searching the PubMed, Web of Science, Cochrane Library, and Embase databases together with the China National Knowledge Infrastructure (CNKI) and the Wanfang database for articles published up to 9 August 2019. The Newcastle-Ottawa scale (NOS) was adapted to evaluate the bias and risks in each eligible study. The data of the external fixation index (EFI), bone grafting, bone and functional results, complications, bone union time and characteristics of participants were extracted. RevMan v.5.3 was used to perform relevant statistical analyses. Relative risk (RR) was used for the binary variables and standard mean difference (SMD) for continuous variables. Each variable included its 95% confidence interval (CI).Results: Five studies, including a total of 199 patients, were included in the meta-analysis. Statistical significance was observed in the EFI (SMD = 0.63, 95% CI: 0.25, 1.01, P = 0.001) and bone grafting (RR = 0.26, 95%CI: 0.15, 0.46, P <0.00001); however, no significance was observed in bone union time (SMD = -0.02, 95% CI: -0.39, 0.35, P = 0.92), bone results (RR = 0.97, 95% CI: 0.91, 1.04, P = 0.41), functional results (RR = 0.96, 95% CI: 0.86, 1.08, P = 0.50) and complications (RR = 0.76, 95% CI: 0.41, 1.39, P = 0.37). Conclusions:AST is preferred from the aspect of minimising the treatment period, whereas BT is superior to AST for reducing bone grafting. Due to the limited number of trials, the meaning of this conclusion should be taken with caution for infected tibial bone defects.

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Treatment of Segmental Tibial Defects Using Acute Bone Shortening Followed by Gradual Lengthening with Circular External Fixator

Cited by 11 publications

References 30 publications

Bone transport versus acute shortening for the management of infected tibial bone defects: a meta-analysis

Bone transport versus acute shortening for the management of infected tibial bone defects: a meta-analysis

Preclinical Animal Models for Segmental Bone Defect Research and Tissue Engineering

Bone transport versus acute shortening for the management of infected tibial bone defects: A meta-analysis

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