Comparison of Treatment Time Index for Management of Bone Defects between Distraction Osteogenesis and External Fixator with Cancellous Bone Graft

Main Article Content

Jarusombat W, MD

Abstract

Objective: To compare the durations of treatment in management of bone defects between distraction osteogenesis and external fixator with cancellous bone graft.


Method: This retrospective study was conducted from October 2000 to August 2010. There were 32 cases of bone loss at the femur and tibia. They were divided into 2 groups: group 1 (15 patients were treated using distraction osteogenesis) and group 2 (17 patients were treated using an external fixator with cancellous bone graft). Both groups were compared based on the duration of treatment and clinical results.


Results: The first group, which was treated with the distraction osteogenesis method, had a duration of treatment of 33.99 days per 1cm of bone defect. The second group, which underwent an external fixator along with a cancellous bone graft, had a duration of treatment of 77.75 days per 1cm of bone defect.


Conclusion: Distraction osteogenesis method had a shorter duration of treatment than the external fixator with bone graft method in managing bone defects.

Article Details

Section
Original Articles

References

1. Christian EP, Bosse MI, Robb CG. Reconstruction of large diaphyseal defects without free fibular transfer, in grade IIIB tibial fracture. J Bone Joint Surg Am. 1989; 71-A(7): 994-1003.
2. Zaidi SRA. The Ilizarov Method. J Pak Orthop Assoc. 2002; 14: 93-102.
3. Deboer HH, Wood MB, Jermans J. Reconstruction of large skeletal defects by vascularized fistula transfer. Int Orthopaedics. 1990; 14: 121-8.
4. Jarusombat W. Management of bone loss by distraction osteogenesis. J Prapokklao Hosp Clin Med Educat Center. 2008; 25(2): 282-7.
5. Green SA. Postoperative management during limb lengthening. Orthop Clin of North America. 1991; 22(4): 723-34.
6. Eldridge JC, Bell DF. Problems with substantial limb lengthening. Orthop Clin of North America. 1991; 22(4): 321-25.
7. Bianchi-Maocchi A, Aronson J. Association for the study and application of the method of Ilizarov group: Operative principles of Ilizarov. Fracture treatment, non union, osteomyelitis, lengthening, deformity correction. Baltimore: Williams and Wilkins. 1991.
8. Mizumoto Y, Moseley T, Drews M, Cooper VN 3rd, Reddi AH. Acceleration of regenerate ossification during distraction osteogenesis with recombinant human bone morphogenetic protein-7. J Bone Joint Surg Am. 2003; 85-A(3): 124-30.
9. Hamanishi C, Kawabata T, Yoshii T, Tanaka S. Bone mineral density changes in distracted callus stimulated by pulsed direct electrical current. Clin Orthop Rel Res. 1995; 312: 247-52.
10. Raschke MJ, Mann JW, Oedekoven G, Claudi BF. Segmental transport after unreamed intramedullary nailing:preliminary report of a monorail’system. Clin Ortho Relat Res. 1992;282; 233-40.
11. Tsuchiya H, Tomita K, Minematsu K, Mori Y, Asada N, Kitano S. Limb salvage using distraction osteogenesis. J Bone Joint Surg Br. 1997; 79(3): 403-11.
12. Song HR, Cho SH, Koo KH, Jeong ST, Park YJ, Ko JH. Tibial bone defects treated by internal bone transport using the Ilizarov method. Int Orthop. 1998; 22(5): 293-7.
13. Magadum MP, Basavaraj CM, Phanecsha MS, Ramesh LJ. Acute compression and lengthening by the Ilizarov technique for infected nonunion of the tibia with large bone defects. Journal of Orthopaedic Surgery. 2006; 14(3): 273-9.