Management of post-traumatic long bone defects: A comparative study based on long-term results

Abstract Background Reconstruction of post-traumatic long bone defects is a formidable problem. To date, the approaches for bony reconstruction remain controversial. Thus, we aimed to compare the different methods in the treatment of patients with post-traumatic long bone defects, based on the long-term functional and self-evaluation results. Methods We retrospectively reviewed data on patients with post-traumatic long bone defects of the lower extremities from January 2006 to January 2015. The patients were divided into three groups according to the surgical method used to treat the defects (group 1, free vascularized fibular transfer; group 2, distraction osteogenesis; group 3, the induced membrane technique). Data including the complication rates, entire treatment period, long-term visual analog scale scores, and Sickness Impact Profile (SIP) scores during follow-up were recorded. Results A total of 317 patients were included, with 106, 132, and 79 patients in groups 1, 2, and 3, respectively. The major complication rates were 22.6%, 25.8%, and 26.6% for the groups (P > 0.05), respectively. The mean treatment durations for bony defects, from surgery to non-protected weight-bearing, were 65.1, 46.5, and 56.6 weeks for each group, respectively. At 2 years postoperatively, the average SIP scores for each group were 10.5, 11.7, and 11.5, respectively (P > 0.05). Conclusion Patients who sustained long bone defects can be advised that either one of these three methods which typically results in long-term outcomes equivalent to others. Level of evidence: retrospective study