Shortening and distraction osteogenesis for the treatment of infected pseudoarthrosis in femur and tibia fractures
Keywords:
Pseudarthrosis, Infection, Osteogenesis, Distraction, External Fixators, ShorteningAbstract
Introduction: This work describes the results obtained with the technique of acute shortening and osteogenesis by distraction for the treatment of infected pseudoarthrosis in femur and tibia in patients of the Hospital Central de la Policía Nacional, Bogotá, Colombia.
Methods: We designed a restrospective, longitudinal, case series study, of the Orthopaedics and Traumatology Service of the Hospital Central de la Policía Nacional, Bogotá, Colombia, between January 1998 and November 2008.
Results: Sixty male patients were included, with an average age of 34.2 years (range between 20 and 65 years). 35% of fractures were femur fractures (21 cases), and 65% were tibial fractures (39 cases). 68.3% of fractures were open fractures (41 cases). 20% were produced by gunshots, including 12 patients, and 80% were produced by car accidents (48 patients). The maturity index was 1.7 month/ cm (SD 0.437) with a range of 1.1-3.6. The main difficulties were related with the screws and with pain. According to the bone results evaluated by Paley’s criteria, 65% were excellent (39 cases), 25% were good (15 cases), 10.0% were fair (6 cases). The functional results were excellent in 26,7% (16 cases), good in 36,7% (22 cases), fair in 35,0% (21 cases), and bad in 1.7% (1 case).
Discussion: The results support the acute shortening and the osteogenesis by distraction as a technique of salvage that gives an adequate option for patients with infected pseudoarthrosis in whom other types of treatment have failed.
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