Clinical research on Orthofix limb reconstruction system for segmental defects in the long bones of the limbs
KONG Zhen
SUN Yong-jian
LI Hua-long
ZUO Rui
Abstract：Objective To summarize the methods of Orthoifx limb reconstruction system in the treatment of segmental defects in the long bones of the limbs and to investigate the clinical results. Methods From January 2009 to September 2013, the clinical data of 42 patients with segmental defects in the long bones of the limbs who were treated with the Orthoifx limb reconstruction system were collected and analyzed. There were 34 males and 8 females, whose average age was 36.4 years old ( range:18-55 years ). There were 43 bone defect sites in all. Congenital tibial joint diseases, chronic osteomyelitis, nonunion, bone tumors and open and comminuted fractures were involved. The mean length of bone defects was 8.7 cm ( range:4-21 cm ) after debridement. One-stage debridement or segmental resection+Orthoifx limb reconstruction were performed on the patients with better soft tissues. Skin-grafting or transfer of skin flap + one-stage or two-stage Orthofix limb reconstruction or shortening and lengthening technique after infection control were used for the patients with infections or soft tissue defects. Bone transport was performed at the 7th or 10th day after osteotomy, with 1 mm/d and 4 times on average. The anteroposterior ( AP ) and lateral X-rays were taken before or after the operation. The transport length and ifxed time were noted. The callus diameter ratios ( CDR ) were calculated based on the X-rays after removal of the external ifxation. The results of bone transport and functions were evaluated by the Paley criteria. The preoperative and postoperative joint functions were graded by the Mayo elbow performance score ( MEPS ), Harris hip score ( HHS ) and Baird-Jackson ankle function score systems, and the treatment outcomes were evaluated. Results All the patients were followed up for an average period of 16.5 months ( range:10-48 months ). The average bone transport length was 8.6cm and the average ifxed time was 15.4 months after the treatment of Orthoifx limb reconstruction system. A favorable prognosis was achieved at 41 bone defects. Recurrence was found in 2 patients with osteomyelitis after the operation, who got healed after continuous irrigation and dressing change. According to the Paley criteria, bony union was excellent in 40 cases and good in 3 cases, and the functional recovery was rated as excellent in 40 cases, good in 16 cases and poor in 1 case. The average CDR was 88.3%after removal of the external ifxation. The MEPS was 63 points in 1 case before the treatment. The mean HHS was ( 60.89±8.87 ) points and the mean Baird-Jackson ankle function score was ( 64.12±6.21 ) points before the treatment. The MEPS was 88 points in 1 case after the treatment. The mean HHS was ( 87±5.45 ) points and the mean Baird-Jackson ankle function score was ( 87.67±5.32 ) points after the treatment. Statistically signiifcant differences existed in the scores of the elbow, hip and ankle ( P<0.01 ). Conclusions The Orthoifx limb reconstruction system is effective in the treatment of segmental defects in the long bones of the limbs with or without soft tissue defects resulted from various causes. However, the treatment method should be personalized, never the same.
Keywords：Fracture ifxationBone remodelingBracesArm bonesBones of lower extremity
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 91-95 )