Treatment of post-traumatic chronic osteomyelitis of lower limbs by bone transport technique using mono-lateral external fixator: Follow-up study of 18 cases.

Abstract

To review the results of the treatment of post-traumatic chronic osteomyelitis of lower limbs by bone transport technique using mono-lateral external fixator. A total of 18 patients with post-traumatic chronic osteomyelitis of lower limbs were treated by bone transport technique using mono-lateral external fixator in this study. Seven cases (patients No. 1-7) were performed early BGPO (autologous ilium bone grafting and plate osteosynthesis) intervention after BT (bone transport). The end results were assessed by the criteria of ASAMI and Paley et al. Some data between the cases with and without the intervention of early BGPO were subjected to statistical analysis of Student's t-test. The overall average time for union was 10.8 months. The average union time of the non-early BGPO cases was 52.27 ± 7.82 weeks while the early BGPO cases took a shorter time of 36.86 ± 5.34 weeks (P < 0.001). The overall average duration from bone transport to removal of external fixator was 10.0 months. The average duration from bone transport to removal of external fixator in the non-early BGPO cases was 51.55 ± 7.45 weeks while the early BGPO cases took a shorter time of 29.29 ± 5.47 weeks (P < 0.001). The overall average of BHI was 1.77 months cm(-1). The average of BHI in the non-early BGPO cases was 2.25 ± 0.25 months cm(-1) and the average BHI of the early BGPO cases was 1.22 ± 0.114 months cm(-1) (P < 0.001). There were 31 additional surgeries and 38 complications in total after bone transport treatment. The bone results were excellent in 15 cases, good in 3 cases. The functional results were excellent in 9 cases, good in 6 cases and fair in 3 cases. 1. Bone transport technique using mono-lateral external fixator is an effective method for the treatment of post-traumatic chronic osteomyelitis. 2. Early BGPO intervention after bone transport is a feasible method to shorten the external fixation time and the total duration of treatment.