Bifocal Compression Distraction for Combined Bone and Soft Tissue Defects in Post-traumatic Tibial Nonunion
Mohammed Samy Ahmed Sharafeldein;
Abstract
A review of the literature coupled with our own experience, reveals that principles of distraction osteogenesis for tibial nonunion is a reliable method achieve union, correct the deformity and restore the normal limb length and maintain limb function.
Both bone transport and acute shortening followed by gradual lengthening are effective methods for management of nonunited tibial fractures with bony defects associated with soft tissue problems.
Preoperative psychological counselling regarding long treatment and support throughout treatment is necessary for successful completion of treatment.
Although the number of complications and ASAMI scores for bone or function were not statistically significant in the two treatment groups, whenever possible, it is better to use the acute shortening and gradual lengthening technique as it is associated with lower EFI and lesser procedures needed to union than bone transport technique. This is mostly due to problems related to the docking site, and a longer time for the transport. However, the deciding factor will be the actual extent of the bone loss.
The treatment of traumatic segmental bone loss is often complicated by presence of soft tissue defects caused by initial injury or as a result of multiple previous operations. Soft tissue defects take different forms, either adherent scar, infected sinus or skin loss, each one of them should be managed with appropriate method. Early good soft tissue coverage
Both bone transport and acute shortening followed by gradual lengthening are effective methods for management of nonunited tibial fractures with bony defects associated with soft tissue problems.
Preoperative psychological counselling regarding long treatment and support throughout treatment is necessary for successful completion of treatment.
Although the number of complications and ASAMI scores for bone or function were not statistically significant in the two treatment groups, whenever possible, it is better to use the acute shortening and gradual lengthening technique as it is associated with lower EFI and lesser procedures needed to union than bone transport technique. This is mostly due to problems related to the docking site, and a longer time for the transport. However, the deciding factor will be the actual extent of the bone loss.
The treatment of traumatic segmental bone loss is often complicated by presence of soft tissue defects caused by initial injury or as a result of multiple previous operations. Soft tissue defects take different forms, either adherent scar, infected sinus or skin loss, each one of them should be managed with appropriate method. Early good soft tissue coverage
Other data
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Open Journal of Orthopedics. 2012;(2012). الضغط والإفتراق ثنائى البؤرة لعلاج الفقدان العظمى وفقدان الأنسجة الرخوة المصاحب لعدم الإلتئام الرضحى لعظمة القصبة | Authors | Mohammed Samy Ahmed Sharafeldein | Issue Date | 2017 |
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