Journal of Musculoskeletal Trauma

Thermal Injury Complicating Improperly Reamed Intramedullary Nailing of the Tibia: A Case Report: Bo Kun Kim, Hyun Dae Shin, Jung Mo Hwang; J Korean Fract Soc 2011;24(2):178-184. Published online April 30, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.2.178

Abstract PDF: Endosteum and bone marrow thermal necrosis caused by reaming during tibial intramedullary nail insertion, and unskilled operation of soft tissue penestration by reamer resulted in chronic osteomyelitis and soft tissue defect. So, several times of free flaps were done but the result was unsuccessful. At last, the authors performed radical necrotic bone resection and internal bone transport using Ilizarov external fixator. The authors report case with literature review.

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Internal Bone Transport in the Management of Tibial Bone Defects: Chang Wug Oh, Woo Kie Min, Hee Soo Kyung, Il Hyung Park, In Ho Jeon, Byung Chul Park, Poong Taek Kim, Young Heon Sohn; J Korean Fract Soc 2005;18(1):36-42. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.36

PURPOSE
To retrospectively review the results of internal bone transport in the management of tibial bone defect using ilizarov fixator.
MATERIALS AND METHODS
We treated 39 cases of tibial bone defect (16 of traumatic bone loss, 23 after treatment of osteomyelitis). The mean age of index procedure was 33.8 years (range, 13~66 years), and all of them had follow-up study for a mean of 3.5 years (range, 1.6~8 years). The mean transported amount was 6.3 cm (range, 2.7~20 cm), and the external fixator was removed after 345 days (range, 120~700 days). The mean external fixation index was 60.3 days/cm (range, 13.1~121.3 days/cm).
RESULTS
Primary union of distraction and docking site was achieved in all, but two patients had failure in union of docking site. Functional results showed 6 excellent, 19 good, 10 fair, and 4 fair. The patients under age 20 showed better functional outcomes than the others. Among 73 complications (incidence, 1.87 cases/ patient), 27 of major complications with residual sequelae occurred in 20 patients. The residual sequelae were more common in the patients who had the concomitant injuries in the same leg.
CONCLUSION
Internal bone transport can solve the large amount of tibial bone defect. However, the complications are not uncommon, which might be related to the concomitant injures in the same leg.

Citations

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Bone Transport Over the Intramedullary Nail for Defects of Long Bone
Jae-Young Roh, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Byung-Chul Park, Woo-Kie Min, Joon-Woo Kim, Chang-Hyun Cho
Journal of the Korean Fracture Society.2008; 21(1): 37. CrossRef
Minimally Invasive Plate Osteosynthesis to Prevent or Treat the Deformity after Distraction Osteogenesis
Chang-Wug Oh, Byung-Chul Park, Il-Hyung Park, Hee-Soo Kyung, Woo-Kie Min, Seung-Hoon Baek, Seung-Kil Baek
The Journal of the Korean Orthopaedic Association.2007; 42(6): 764. CrossRef

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Internal Bone Transport for Treatment of Infected Non-union of Long Bone: Han Suk Ko, Byung Jik Kim, Young Lim, Jeong Gook Seo, Jin Ku Kim, Dong Hun Lee; J Korean Soc Fract 1998;11(3):623-628. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.623

Abstract PDF: Infected nonunion of long bone frequently accompanies with bone loss, because of the outcome of initial trauma or iatrogenic result from sequestra resection. In this study, infected and ununited long bone fracture was treated with internal bone transport technique which was first discribed by G.A. Ilizarov. There were eleven tibial and two femural nonunion. The mean number of admission was 2.8 times; mean number of operation was 8 times; mean duration of average healing index was 1.95 month/cm. All infections were cured and all nonunions were united. Functional result was excellent in 5 cases (of 13 cases), good in 5, fair in 2, and 1 had poor result. Many complication had been observed. All had infection of pin site and pain at least one time, 5 had stiff knee, 9 had stiff ankle, early consolidation(1), delay consolidation(3), tibiofibular synostosis(5), nerve injury(1), refracture after union(1), angular deformity over 5 degree(7), rotational deformity over 10 degree(2).

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