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Archives of Orthopaedic and Trauma Surgery

, Volume 131, Issue 2, pp 229–234 | Cite as

Segmental transports for posttraumatic lower extremity bone defects: are femoral bone transports safer than tibial?

  • Emmanouil LiodakisEmail author
  • Mohamed Kenawey
  • Christian Krettek
  • Max Ettinger
  • Michael Jagodzinski
  • Stefan Hankemeier
Trauma Surgery

Abstract

Background

The long-term outcomes following femoral and tibial segment transports are not well documented. Purpose of the study is to compare the complication rates and life quality scores of femoral and tibial transports in order to find what are the complication rates of femoral and tibial monorail bone transports and if they are different?

Methods

We retrospectively analyzed the medical records of 8 femoral and 14 tibial consecutive segment transports performed with the monorail technique between 2001 and 2008 in our institution. Mean follow-up was 5.1 ± 2.1 years with a minimum follow-up of 2 years. Aetiology of the defects was posttraumatic in all cases. Four femoral (50%) and nine tibial (64%) fractures were open. The Short Form-36 (SF-36) health survey was used to compare the life quality after femoral and tibial bone transports. The Mann–Whiney U test, Fisher exact test, and the Student’s two tailed t-test were used for statistical analysis. P ≤ 0.05 was considered to be statistically significant.

Results

The tibial transport was associated with higher rates of severe complications and additional procedures (1.5 ± 0.9 vs. 3.4 ± 2.7, p = 0.048). Three patients of the tibial group were amputated because of recurrent infections and one developed a complete regenerate insufficiency that was treated with partial diaphyseal tibial replacement. Contrary to that none of patients of the femoral group developed a complete regenerate insufficiency or was amputated.

Conclusions

Tibial bone transports have a higher rate of complete and incomplete regenerate insufficiency and can more often end in an amputation. The authors suggest systematic weekly controls of the CRP value and of the callus formation in patients with posttraumatic tibia bone transports. Further comparative studies comparing the results of bone transports with and without intramedullary implants are necessary.

Keywords

Bone transport Monorail technique Femoral and tibial complications 

Notes

Conflict of interest statement

There was no financial support for this study. None of the authors have received or will receive benefits for professional or personal use from a commercial party related directly or indirectly to the subject of this article. Each author certifies that he has no commercial associations (e.g, consultancies, stock ownership, equity interest, etc.) that might pose a conflict of interest in connection with the submitted article.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Emmanouil Liodakis
    • 1
    Email author
  • Mohamed Kenawey
    • 1
  • Christian Krettek
    • 1
  • Max Ettinger
    • 1
  • Michael Jagodzinski
    • 1
  • Stefan Hankemeier
    • 1
  1. 1.Trauma DepartmentHannover Medical SchoolHannoverGermany

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