The Challenges of Monoaxial Bone Transport in Orthopedics and Traumatology.
BACKGROUND
Bone defects represent the main challenging problem for the orthopedic surgeon and, consequently, they increase the duration of hospitalization, risk of complications and health expenditures. The aim of our observational, descriptive and retrospective study is to evaluate the outcomes of patients treated with a mo-nolateral external fixator for bone defects greater than 3 cm.


MATERIAL AND METHODS
Between January 2003 and January 2013, 21 patients were treated at our center by bone transfer with a monolateral external fixator. The main etiologies were trauma in 17 cases (80.9%) and tumors in 4 cases (19.1%). Mean follow-up was 5 years for non-union and 3 years for tumors. Our clinical evaluation was based on ASAMI (Association for the Study ad Application of the Methods of Ilizarov) scores during this follow-up period.


RESULTS
The functional outcomes, based on ASAMI scores, were excellent in 12 cases, good in 7 and poor in 2.


CONCLUSION
1. A review of the literature related to our experience shows that bone transport is an effective tech-nique to repair loss of bone in the lower limbs. The use of a system of external fixation enables corrective actions throughout the treatment that can be in-dividualized on a case-by-case basis. In our experience, the LRS fixator (Orthofix) is a sta-ble, easy-to-use and very handy device. 2. In situations where soft tissue reconstruction procedures are needed, the size and shape of the splint should be such as not to constitute an obstacle. Fur-thermore, the use of pins rather than transfixation wires eliminates the risk of neuro / vascu-lar injury such as may occur during the application of a circular fixator. 3. The analysis of the cases presented here indicates that where possible the technique of bone transport produces good results and can often salvage the limb. Amputation should be reserved only for cases where the general and / or local preoperative status indicate that the surgeon can expect a poor result or when the compliance of the patient is determined to be inadequate.
['Bisaccia|Michele|M|', 'Rinonapoli|Giuseppe|G|', 'Meccariello|Luigi|L|', 'Caraffa|Auro|A|', 'Cukierman|Bartosz|B|', 'Iborra|Julio Ribes|JR|']
D000293:Adolescent D000328:Adult D001858:Bone Nails D016267:External Fixators D005260:Female D006801:Humans D018889:Ilizarov Technique D008297:Male D008875:Middle Aged D019637:Orthopedic Procedures D009985:Orthopedics D012189:Retrospective Studies D013978:Tibial Fractures D014194:Traumatology D016896:Treatment Outcome D055815:Young Adult
bone transport bone defects monolateral external fixation bone infection skeletal tumor