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Femoral bone transport by a monolateral external fixator with or without the use of intramedullary nail: a single-department retrospective study

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Backgrounds

Treatment for bone defect remains a challenge for orthopedists. Bone transport gives an effective alternative, which can be performed with an external fixator alone or combined with an intramedullary nail. Each has its advantages and disadvantages. We present a retrospective study to find out the optimal choice by evaluating the outcomes of treatment for femoral bone defect with two methods.

Methods

Two groups of patients, the monolateral external fixator alone (group A, n = 13) and the monolateral external fixator combined with intramedullary nail (group B, n = 15), were compared. Duration of the external fixator, external fixator index, radiographic consolidation index, complication, and total cost for treatment was also recorded. A modified classification of the Association for the Study and Application of the Method of Ilizarov (ASAMI) was used to assess results in two groups of patients; another SF-36 health survey questionnaire was used to assess the life qualities patients of two groups.

Results

Healing was achieved in 13/13 and 13/15 of the two groups, respectively. The rates of complications were significantly higher in the group A. Two patients performed amputations because of persistent deep infections in group B. Statistically significant difference was found when comparing ASAMI scores and categories of the SF-36 health survey.

Conclusions

Bone transport by monolateral external fixator with the use of intramedullary nail reduces the incidence of complication and the duration of external fixator time that give patients a better life quality in both physical and emotional. However, if chronic osteitis exists, bone transport should be treated with monolateral external fixator alone due to a lower rate of amputations.

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Acknowledgments

We thank Miss Jing Wan for her editorial and secretarial assistance to this manuscript.

Conflict of interest

All authors declare no conflict of interest with this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha, 410007, Hunan, People’s Republic of China

    Jun Wan

  2. Department of Orthopaedics, Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, People’s Republic of China

    Lin Ling, Xiang-sheng Zhang & Zhi-hong Li

Authors
  1. Jun Wan
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  2. Lin Ling
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  3. Xiang-sheng Zhang
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  4. Zhi-hong Li
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Corresponding author

Correspondence to Xiang-sheng Zhang.

Additional information

Jun Wan and Lin Ling contribute equally to this manuscript.

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Wan, J., Ling, L., Zhang, Xs. et al. Femoral bone transport by a monolateral external fixator with or without the use of intramedullary nail: a single-department retrospective study. Eur J Orthop Surg Traumatol 23, 457–464 (2013). https://doi.org/10.1007/s00590-012-1008-x

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  • DOI: https://doi.org/10.1007/s00590-012-1008-x

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