RT Journal Article
ID 74ef475600b308f0
A1 Karargyris, Orestis 
A1 Romoudis, Pavlos 
A1 Morassi, Lampros Giuseppe 
A1 Zafeiris, Christos 
A1 Mavrogenis, Andreas F.
A1 Polyzois, Vasileios 
A1 Pneumaticos, Spyridon G.
T1 Distraction over Nail Using Circular External Fixation for Septic Pseudarthrosis of the Tibia
JF Journal of Long-Term Effects of Medical Implants
JO JLT
YR 2012
FD 2013-02-12
VO 22
IS 2
SP 137
OP 143
K1 Bone transport; Intramedullary nailing; Circular external fixation.
AB We present a report of nine patients (eight women and one man; mean age 37 years) from 2010 to 2012 with septic pseudarthrosis of the tibia treated with bone transport over an intramedullary nail using a circular external fixator. The mean follow-up was 15 months (range: 10−21 months). A twostage approach was used. At the first stage, removal of the primary osteosynthesis and extensive bone debridement to healthy, bleeding bone margins was performed. The bone defect was packed with antibiotic loaded cement beads, and stabilization of the tibia was done with a unilateral external fixator or with
a long leg posterior splint. The mean size of bone defect was 4 cm (range: 3.5−5.5 cm). At the second
stage, two consecutive negative wound cultures and normal values of blood cell count, C-reactive protein
(CRP), and estimated sedimentation rate (ESR) were obtained. Then we reamed and locked the intramedullary
nailing of the tibia, applied a circular external fixator, and performed percutaneous corticotomy of the tibia opposite the site of the bone defect. Bone distraction over the nail was initiated at the eighth postoperative day at a rate of 1 mm/day. At the last follow-up, union was achieved in all cases without recurrence of bone infection. All patients experienced excellent (n=3) or good (n=6) knee and ankle function, as well as complete return to their daily activities. Two patients experienced pin-tract infection, and one patient experienced anterior knee pain at the entry point of the nail.
PB Begell House
LK https://www.dl.begellhouse.com/journals/1bef42082d7a0fdf,4bae91265145243a,74ef475600b308f0.html