Plate-assisted Bone Segment Transport With Motorized Lengthening Nails and Locking Plates: A Technique to Treat Femoral and Tibial Bone Defects.

Journal

Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
ISSN: 2474-7661
Titre abrégé: J Am Acad Orthop Surg Glob Res Rev
Pays: United States
ID NLM: 101724868

Informations de publication

Date de publication:
Aug 2019
Historique:
entrez: 9 10 2019
pubmed: 9 10 2019
medline: 9 10 2019
Statut: epublish

Résumé

This article describes a new bone transport technique for femoral and tibial bone defects using lengthening nails combined with locking plates. We term it plate-assisted bone segment transport (PABST). Nine patients with five femoral and four tibial bone defects from open fractures or malignancies were treated between 2016 and 2018. Mean femoral defect length was 9.3 cm (range 7 to 11.5). Mean tibial defect was 8.9 cm (range 4.8 to 15). The patients were evaluated for time to weight bearing, consolidation index, mechanical axis deviation, and limb length discrepancy. Seven of nine patients have fully consolidated. The mean consolidation time was 6.6 months. The consolidation index was 0.9 (femur) and 1.26 (tibia) mo/cm. Two patients required supplementary lengthening. One patient had mild varus, one mild valgus; the remainder had a normal mechanical axis. Limb length discrepancy remained acceptable in all patients. The main complications were heterotopic ossification, delayed healing, and reduced knee motion. Bone transport with lengthening nails and locking plates is an effective and patient-friendly way of treating bone defects, eliminating the adverse effects of external fixation and reducing treatment time. The plate provides stability during transport and docking; it can address concomitant fractures and facilitates acute shortenings.

Identifiants

DOI: 10.5435/JAAOSGlobal-D-19-00064 PMID: 31592010 PMC: PMC6754216
pubmed: 31592010
doi: 10.5435/JAAOSGlobal-D-19-00064
pii: JAAOSGlobal-D-19-00064
pmc: PMC6754216
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e064

Subventions

Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States

Informations de copyright

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.

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Auteurs

Ulrik Kähler Olesen (UK)

Rigshospitalet, Department of Orthopedic Surgery, Copenhagen Limb Lengthening and Bone Reconstruction Unit, Denmark (Dr. Kähler Olesen, Dr. Nygaard, and Dr. Singh); the Memorial Sloan Kettering Cancer Center, Orthopedic Service, New York City, NY (Dr. Prince); the Sinai Hospital, Rubin Institute for Advanced Orthopedics, International Center for Limb Lengthening, Baltimore, MD (Dr. Herzenberg); the Springfield Clinic, Springfield, IL (Dr. Gardner); the Nuffield Orthopedic Centre, Oxford University Hospitals, UK (Dr. McNally); and the Children's University Hospital, Dublin, Ireland (Dr. Green).

Tobias Nygaard (T)

Rigshospitalet, Department of Orthopedic Surgery, Copenhagen Limb Lengthening and Bone Reconstruction Unit, Denmark (Dr. Kähler Olesen, Dr. Nygaard, and Dr. Singh); the Memorial Sloan Kettering Cancer Center, Orthopedic Service, New York City, NY (Dr. Prince); the Sinai Hospital, Rubin Institute for Advanced Orthopedics, International Center for Limb Lengthening, Baltimore, MD (Dr. Herzenberg); the Springfield Clinic, Springfield, IL (Dr. Gardner); the Nuffield Orthopedic Centre, Oxford University Hospitals, UK (Dr. McNally); and the Children's University Hospital, Dublin, Ireland (Dr. Green).

Daniel E Prince (DE)

Rigshospitalet, Department of Orthopedic Surgery, Copenhagen Limb Lengthening and Bone Reconstruction Unit, Denmark (Dr. Kähler Olesen, Dr. Nygaard, and Dr. Singh); the Memorial Sloan Kettering Cancer Center, Orthopedic Service, New York City, NY (Dr. Prince); the Sinai Hospital, Rubin Institute for Advanced Orthopedics, International Center for Limb Lengthening, Baltimore, MD (Dr. Herzenberg); the Springfield Clinic, Springfield, IL (Dr. Gardner); the Nuffield Orthopedic Centre, Oxford University Hospitals, UK (Dr. McNally); and the Children's University Hospital, Dublin, Ireland (Dr. Green).

Matthew P Gardner (MP)

Rigshospitalet, Department of Orthopedic Surgery, Copenhagen Limb Lengthening and Bone Reconstruction Unit, Denmark (Dr. Kähler Olesen, Dr. Nygaard, and Dr. Singh); the Memorial Sloan Kettering Cancer Center, Orthopedic Service, New York City, NY (Dr. Prince); the Sinai Hospital, Rubin Institute for Advanced Orthopedics, International Center for Limb Lengthening, Baltimore, MD (Dr. Herzenberg); the Springfield Clinic, Springfield, IL (Dr. Gardner); the Nuffield Orthopedic Centre, Oxford University Hospitals, UK (Dr. McNally); and the Children's University Hospital, Dublin, Ireland (Dr. Green).

Upender Martin Singh (UM)

Rigshospitalet, Department of Orthopedic Surgery, Copenhagen Limb Lengthening and Bone Reconstruction Unit, Denmark (Dr. Kähler Olesen, Dr. Nygaard, and Dr. Singh); the Memorial Sloan Kettering Cancer Center, Orthopedic Service, New York City, NY (Dr. Prince); the Sinai Hospital, Rubin Institute for Advanced Orthopedics, International Center for Limb Lengthening, Baltimore, MD (Dr. Herzenberg); the Springfield Clinic, Springfield, IL (Dr. Gardner); the Nuffield Orthopedic Centre, Oxford University Hospitals, UK (Dr. McNally); and the Children's University Hospital, Dublin, Ireland (Dr. Green).

Martin A McNally (MA)

Rigshospitalet, Department of Orthopedic Surgery, Copenhagen Limb Lengthening and Bone Reconstruction Unit, Denmark (Dr. Kähler Olesen, Dr. Nygaard, and Dr. Singh); the Memorial Sloan Kettering Cancer Center, Orthopedic Service, New York City, NY (Dr. Prince); the Sinai Hospital, Rubin Institute for Advanced Orthopedics, International Center for Limb Lengthening, Baltimore, MD (Dr. Herzenberg); the Springfield Clinic, Springfield, IL (Dr. Gardner); the Nuffield Orthopedic Centre, Oxford University Hospitals, UK (Dr. McNally); and the Children's University Hospital, Dublin, Ireland (Dr. Green).

Connor J Green (CJ)

Rigshospitalet, Department of Orthopedic Surgery, Copenhagen Limb Lengthening and Bone Reconstruction Unit, Denmark (Dr. Kähler Olesen, Dr. Nygaard, and Dr. Singh); the Memorial Sloan Kettering Cancer Center, Orthopedic Service, New York City, NY (Dr. Prince); the Sinai Hospital, Rubin Institute for Advanced Orthopedics, International Center for Limb Lengthening, Baltimore, MD (Dr. Herzenberg); the Springfield Clinic, Springfield, IL (Dr. Gardner); the Nuffield Orthopedic Centre, Oxford University Hospitals, UK (Dr. McNally); and the Children's University Hospital, Dublin, Ireland (Dr. Green).

John E Herzenberg (JE)

Rigshospitalet, Department of Orthopedic Surgery, Copenhagen Limb Lengthening and Bone Reconstruction Unit, Denmark (Dr. Kähler Olesen, Dr. Nygaard, and Dr. Singh); the Memorial Sloan Kettering Cancer Center, Orthopedic Service, New York City, NY (Dr. Prince); the Sinai Hospital, Rubin Institute for Advanced Orthopedics, International Center for Limb Lengthening, Baltimore, MD (Dr. Herzenberg); the Springfield Clinic, Springfield, IL (Dr. Gardner); the Nuffield Orthopedic Centre, Oxford University Hospitals, UK (Dr. McNally); and the Children's University Hospital, Dublin, Ireland (Dr. Green).

Classifications MeSH