Efficacy of stage one external unilateral frame fixation combined with stage two internal plate fixation in the femoral bone transport
10.3760/cma.j.cn115530-20240405-00149
- VernacularTitle:一期单边外固定支架结合二期钢板内固定在股骨骨搬移治疗中的应用
- Author:
Rui HU
1
;
Li YAN
1
;
Shanqing LI
1
;
Ying AN
1
;
Jin ZHU
1
;
Chunbao YANG
1
;
Jianxiong ZHENG
1
Author Information
1. 武汉市第四医院骨科，武汉 430033
- Publication Type:Journal Article
- Keywords:
Femur;
External fixators;
Ilizarov technique;
Fracture fixation, internal;
Bone plates;
Bone defects
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(12):1047-1054
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy of stage one external unilateral frame fixation combined with stage two internal plate fixation in the femoral bone transport for femoral defects or deformity.Methods:A retrospective study was conducted to analyze the clinical data of 24 patients who had been treated by femoral bone transport for femoral defects or deformity at Department of Orthopaedic Surgery, The Fourth Hospital of Wuhan from January 2013 to January 2023. There were 16 males and 8 females with an age of (46.2±14.7) years. The causes for femoral bone transport were infectious bone defects caused by trauma or surgery in 13 cases, congenital length disparity of bilateral femurs in 6 cases, and chronic femoral osteomyelitis caused by non-traumatic factors in 5 cases. All patients were treated by external fixation with an unilateral frame to carry out femoral bone transport at stage one followed by internal plate fixation after the femoral bone transport was completed at stage two. Postoperative complications, functional recovery of the lower extremity at 12 months after internal fixation and quality of life were recorded.Results:The 24 patients were followed up for (30.2±8.6) months. The stretch velocity of bone elongation was (0.87±0.04) mm/d, the external fixation time (4.2±1.4) months, the duration between internal plate fixation and end of bone transport (8.2±4.9) weeks, and the bony union time (15.9±4.7) months. None of the 24 patients experienced severe limb infection, and their wounds healed without any neurovascular lesions. By the Paley scoring criteria, the lower limb function at 12 months after internal fixation was assessed as excellent in 16 cases, as good in 6 cases, and as fair in 2 cases, giving an excellent and good rate of 91.7% (22/24). By the SF-36 Quality of Life Assessment Form, the quality of life of the patients scored (87.9±4.1) points.Conclusion:In the femoral bone transport for femoral defects or deformity, the sequential strategy of external unilateral frame fixation at stage one combined with internal plate fixation at stage two can avoid complications caused by long-term frame carrying, reduce incidence of delayed union, and enhance the quality of life of patients.
