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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 6, 783-789.
doi: 10.1302/0301-620X.88B6.17515  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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An alternative method for the treatment of nonunion of the tibia with bone loss

C. Sen, MD, Orthopaedic Surgeon, Associate Professor1; L. Eralp, MD, Orthopaedic Surgeon, Associate Professor2; T. Gunes, MD, Orthopaedic Surgeon, Assistant Professor1; M. Erdem, MD, Orthopaedic Surgeon, Assistant Professor1; V. E. Ozden, MD, Orthopaedic Surgeon2; and M. Kocaoglu, MD, Orthopaedic Surgeon, Professor2

1 Department of Orthopaedics and Traumatology, Medical School of Gaziosmanpasa University, Tokat, Turkey
2 Department of Orthopaedics and Traumatology Medical Faculty of Istanbul University, Istanbul, Turkey.

Correspondence should be sent to Dr C. Sen; e-mail: senc64{at}yahoo.com

In this retrospective study we evaluated the method of acute shortening and distraction osteogenesis for the treatment of tibial nonunion with bone loss in 17 patients with a mean age of 36 years (10 to 58). The mean bone loss was 5.6 cm (3 to 10). In infected cases, we performed the treatment in two stages. The mean follow-up time was 43.5 months (24 to 96). The mean time in external fixation was 8.0 months (4 to 13) and the mean external fixator index was 1.4 months/cm (1.1 to 1.8). There was no recurrence of infection. The bone evaluation results were excellent in 16 patients and good in one, while functional results were excellent in 15 and good in two. The complication rate was 1.2 per patient.

We conclude that acute shortening and distraction osteogenesis is a safe, reliable and successful method for the treatment of tibial nonunion with bone loss, with a shorter period of treatment and lower rate of complication.




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An alternative method for the treatment of nonunion of the tibia with bone loss
Mahmoud A. El-Rosasy
J Bone Joint Surg Br Online, 6 Jul 2006 [Full text]

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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General