Cable-asisted bone transport versus circular external fixators-asisted bone transport in the management of bone defects of the Tibia: clinical and imaging results

被引:0
作者
Alibakan, Guengoer [1 ]
Kanar, Muharrem [1 ]
Armagan, Raffi [1 ]
Sulek, Yusuf [1 ]
Altuntas, Yusuf [1 ]
Eren, Osman Tugrul [1 ]
机构
[1] Hlth Sci Univ Sisli Hamidiye Etfal Training & Res, Istanbul, Turkiye
来源
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH | 2025年 / 20卷 / 01期
关键词
Tibial fractures; Bone defects; External fixator; Distraction osteogenesis; Fracture healing; Bone regeneration; Pain measurement; Complications; Infection; Functional recovery; Treatment outcome; DISTRACTION OSTEOGENESIS; INFECTED NONUNION; ILIZAROV METHOD; ORTHOFIX LRS; RECONSTRUCTION; COMPLICATIONS; OSTEOMYELITIS; EXPERIENCE; FRACTURE; OUTCOMES;
D O I
10.1186/s13018-025-05648-9
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose The aim of this study was to compare the efficacy, clinical outcomes, and complications of cable-asisted bone transport (CASt) and circular external fixator-assisted bone transport (CEFt) methods in the management of bone defects of the tibia. Methods A retrospective analysis was conducted on 32 patients who underwent segmental bone transport for tibial bone defects between January 2006 and January 2020 and met the study inclusion criteria. Patients were categorized into two groups: CASt group (n = 16) and CEFt group (n = 16). The primary outcome measures included radiological parameters (External Fixator Index (EFI), Radiological Consolidation Time (RCT), and Radiological Consolidation Index (RCI)), functional independence (Lower Extremity Functional Index, LEFI) and functional outcomes (ASAMI Bone and Functional Scores). Secondary outcomes included pain levels (Visual Analog Scale, VAS), and complication rates (Paley's and Checketts-Otterburn classifications). Results The CASt method resulted in significantly reduced pain scores during distraction (VAS: 4.81 +/- 0.98 vs. 6.75 +/- 0.86; p = 0.001). Pin-tract infection rates were significantly lower in the CASt group compared to the CEFt group (50% vs. 93.8%; p = 0.013). There was no significant difference between the groups in radiological (EFI, RCT, RCI) and functional outcomes (ASAMI scores) (p > 0.05). Conclusion Both CASt and CEFt methods are effective and reliable options in the management of bone defects of the tibia. However, CASt offers advantages such as lower pin-tract infection rates and less pain during distraction, resulting in greater patient comfort and compliance. Given its less invasive nature, CASt may be preferable in patients at higher risk of infection or with a low pain threshold. However, the technical complexity of this method requires experienced surgical application.
引用
收藏
页数:13
相关论文
共 43 条
  • [1] The psychological impact of external fixation using the Ilizarov or Orthofix LRS method to treat tibial osteomyelitis with a bone defect
    Abulaiti, Alimujiang
    Yilihamu, Yilizati
    Yasheng, Tayierjiang
    Alike, Yamuhanmode
    Yusufu, Aihemaitijiang
    [J]. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2017, 48 (12): : 2842 - 2846
  • [2] Ilizarov bone transport and treatment of critical-sized tibial bone defects: a narrative review
    Aktuglu, Kemal
    Erol, Kubilay
    Vahabi, Arman
    [J]. JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY, 2019, 20 (01)
  • [3] Monofocal bone transport technique for bone defects greater than 5 cm in tibia: our experience in a case series of 24 patients
    Aktuglu, Kemal
    Gunay, Huseyin
    Alakbarov, Jabrayil
    [J]. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2016, 47 : S40 - S46
  • [4] Treatment of Tibial and Femoral Bone Defects With Bone Transport Over an Intramedullary Nail
    Bas, Ali
    Daldal, Fehmi
    Eralp, Levent
    Kocaoglu, Mehmet
    Uludag, Serkan
    Sari, Seckin
    [J]. JOURNAL OF ORTHOPAEDIC TRAUMA, 2020, 34 (10) : E353 - E359
  • [5] TIBIAL BONE TRANSPORT OVER AN INTRAMEDULLARY NAIL USING CABLE AND PULLEYS
    Bernstein, Mitchell
    Fragomen, Austin
    Rozbruch, S. Robert
    [J]. JBJS ESSENTIAL SURGICAL TECHNIQUES, 2018, 8 (01):
  • [6] Complications associated with distraction osteogenesis for infected nonunion of the femoral shaft in the presence of a bone defect A RETROSPECTIVE SERIES
    Blum, A. L. L.
    Bongiovanni, J. C.
    Morgan, S. J.
    Flierl, M. A.
    dos Reis, F. Baldy
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2010, 92B (04): : 565 - 570
  • [7] Cao Zming, 2023, J Orthop Surg Res, V18, P1, DOI [10.1186/S13018-023-03783-9/TABLES/3, DOI 10.1186/S13018-023-03783-9/TABLES/3]
  • [8] Docking site complications analysis of Ilizarov bone transport technique in the treatment of tibial bone defects
    Feng, Dongwei
    Zhang, Yaxin
    Wu, Weize
    Jia, Heping
    Ma, Chuang
    [J]. JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH, 2023, 18 (01)
  • [9] Plate-Assisted Bone Segment Transport Versus Precice Bone Transport Nail
    Gardner, Matthew P.
    Beason, Austin M.
    [J]. JOURNAL OF ORTHOPAEDIC TRAUMA, 2021, 35 : S19 - S24
  • [10] Bone transport using the Ilizarov method: a review of complications in 100 consecutive cases
    Iacobellis, Claudio
    Berizzi, Antonio
    Aldegheri, Roberto
    [J]. STRATEGIES IN TRAUMA AND LIMB RECONSTRUCTION, 2010, 5 (01): : 17 - 22