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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Bone transport versus acute shortening for the management of infected tibial non-unions with bone defects
Injury, Volume 48, No. 10, Year 2017
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Description
Introduction This study compared bone transport to acute shortening/lengthening in a series of infected tibial segmental defects from 3 to 10 cm in length. Methods In a retrospective comparative study 42 patients treated for infected tibial non-union with segmental bone loss measuring between 3 and 10 cm were included. Group A was treated with bone transport and Group B with acute shortening/lengthening. All patients were treated by Ilizarov methods for gradual correction as bi-focal or tri-focal treatment; the treating surgeon selected either transport or acute shortening based on clinical considerations. The principle outcome measure was the external fixation index (EFI); secondary outcome measures included functional and bone results, and complication rates. Results The mean size of the bone defect was 7 cm in Group A, and 5.8 cm in Group B. The mean time in external fixation in Group A was 12.5 months, and in Group B was 10.1 months. The external fixation index (EFI) measured 1.8 months/cm in Group A and 1.7 months/cm in Group B (P = 0.09). Minor complications were 1.2 per patient in the transport group and 0.5 per patient in the acute shortening group (P = 0.00002). Major complications were 1.0 per patient in the transport group versus 0.4 per patient in the acute shortening group (P = 0.0003). Complications with permanent residual effects (sequelae) were 0.5 per patient in the transport group versus 0.3 per patient in the acute shortening group (P = 0.28). Conclusions While both techniques demonstrated excellent results, acute shortening/lengthening demonstrated a lower rate of complications and a slightly better radiographic outcome. Bone grafting of the docking site was often required with both procedures. Level of evidence: Level III; Retrospective comparative study © 2017 Elsevier Ltd
Authors & Co-Authors
Tetsworth, Kevin Dorland
Australia, Brisbane
Royal Brisbane and Women's Hospital
Australia, Brisbane
The University of Queensland
Australia, Brisbane
Orthopaedic Research Centre of Australia
Vaida Glatt, Vaida
Australia, Brisbane
Orthopaedic Research Centre of Australia
United States, San Antonio
University of Texas Health Science Center at San Antonio
Hohmann, Erik
Australia, Brisbane
The University of Queensland
Australia, Brisbane
Orthopaedic Research Centre of Australia
Australia, Rockhampton
Cquniversity Australia
Herzenberg, John E.
United States, Baltimore
Sinai Hospital of Baltimore
Statistics
Citations: 91
Authors: 4
Affiliations: 8
Identifiers
Doi:
10.1016/j.injury.2017.07.018
ISSN:
00201383
Research Areas
Health System And Policy
Study Design
Cohort Study