Treatment of Post-Traumatic Diaphyseal and Distal Tibial Bone Defects by Distraction Osteogenesis: A Monocentric
Danilo Leonetti1, Lorenza Siracusano1, Viktor Dietrich Schick1
1Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Section of Orthopaedic and Trauma Surgery, University of Messina, A.O.U. Policlinico "G. Martino", 98124 Messina, Italy.
Abstract:
Background: Distraction osteogenesis (DO) and the Masquelet technique are currently the preferred treatment options for bone defects larger than 5 cm. Methods: Between January 2019 and December 2023, 19 patients were treated with DO for post-traumatic tibial defects at our institution. The results were evaluated using the Association for the Study and Application of the Method of Ilizarov (ASAMI) scoring system. Results: Patients' mean age was 32.42 years. The mean defect size was 4.8 cm (range 3.2-8.1 cm), and the mean external fixation time was 21.31 weeks. Bone union was reached on average after 25.9 weeks. The mean follow-up time was 3.7 years. The mean leg length discrepancy at the final follow-up was 0.83 cm. Using the ASAMI system, the functional results were excellent in eight patients, good in eight, and fair in two, with one case of failure; the bone results were excellent in ten patients, good in six, fair in two, and poor in one. Conclusions: DO for the treatment of tibial defects has the potential to yield favourable outcomes, provided that the method is performed correctly. Multicentre prospective studies would allow for more definitive conclusions to be made.
