Abstract
Background: The purpose of this study is to evaluate the outcomes of single-level bone transport in the treatment of femoral bone defects after radical debridement, which were caused by infections.Methods: Clinical and radiographic data of patients with infected femoral nonunion treated with a unilateral external fixator (Orthofix limb reconstruction system, LRS) at our hospital from 2010 to 2019 were analyzed retrospectively. The Association for the Study and Application of the Method of Ilizarov (ASAMI) standard was applied to assess the bone and functional outcomes and postoperative complications evaluated by Paley classification. Results: Seventy-six cases of infected femoral bone defects (31 proximal, 19 intermediate, and 26 distal) were managed by single-level bone transport using a unilateral external fixator with a mean follow-up time of 30.8 (23 to 41) months. There were 58 men (76.3%) and 18 women (23.6%), with a mean age of 38.8 years (range, 23 – 60 years). The bone union was achieved in 76 cases with a mean time of 6.9 months (range, 5-8 months). Complications included 29 cases (38.1%) of pin tract infection, 7 cases (9.2%) of muscle contractures, 3 cases (7.9%) of joint stiffness, 13 cases (17.1%) of axial deviation, 2 cases (2.6%) of delayed union, one case (1.3%) of nonunion, and none (0%) of transport gap re-fracture. One patient (1.3%) was scheduled for knee arthroplasty when bone transport treatment ended.Conclusions: Bone transport in the reconstruction of femoral bone defects using unilateral external rail fixator had a satisfactory rate of bone healing and limb function recovery. Complications of distal femoral bone transport were more severe than other sites, but the complication rate was the least of the three. Complications of the proximal were comparable to the intermediate, and soft-tissue-related complications were more likely to occur in the intermediate transport.
Treatment of Tibial and Femoral Bone Defects With Bone Transport Over an Intramedullary Nail