Current Management of Diaphyseal Long Bone Defects-A Multidisciplinary and International Perspective

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Bone Reconstruction

Background:

• Segmental long bone defects present significant challenges in trauma and orthopedic surgery.
• Treatment decisions are influenced by defect etiology, patient condition, and surgeon's approach.
• Reconstruction is considered for defects of 2-3 cm or larger, particularly in lower limbs.

Purpose of the Study:

• To provide an international overview of current concepts in repair and reconstruction techniques for segmental long bone defects.
• To focus on autologous techniques due to limited allograft availability and potentially poorer outcomes.
• To consolidate information on managing complex bone defects.

Main Methods:

• Review of current literature on long bone defect repair and reconstruction.
• Categorization of techniques into repair (e.g., distraction osteogenesis) and reconstruction (e.g., autografts, Masquelet technique).
• Emphasis on autologous bone grafting and related reconstructive methods.

Main Results:

• Various techniques exist, broadly classified as repair or reconstruction.
• Distraction osteogenesis is a basis for repair techniques.
• Autologous grafts (vascularized or Masquelet technique) and allografts are reconstructive options, with a focus on autologous methods.

Conclusions:

• Autologous techniques are preferred for reconstructing segmental long bone defects.
• A multidisciplinary assessment considering patient comorbidities and demands is crucial.
• This review offers an aligned perspective on managing these challenging bone defects.