Single and Double Level Bone Transport in the Treatment of Patients with Femoral Defect Caused by Chronic Osteomyelitis
Objective: To investigate the efficacy and complications of single and double level bone transport in the treatment of patients with femoral defect caused by chronic osteomyelitis. Methods: The clinical data of 42 patients with femoral defect caused by chronic osteomyelitis treated in our hospital from January 2014 to June 2018 were analyzed retrospectively. Demographic data include sex, age, injury mechanism, postoperative defect size, transport type (single or double level), time of mineralization in distracted region, external fixator index (EFI), knee joint HSS score, ASAMI score and postoperative complications. Results: A total of 35 cases were followed up successfully, including 28 males and 7 females, 16 cases in single level and 19 cases in double level bone transport. The average follow up time was 44.77 ± 14.72 months, the average age was 30.89 ± 10.62 years, the average postoperative defect size was 9.94 ± 3.97 cm, the average external fixation index was 1.86 ± 0.55/cm. According to ASAMI scoring system, bony results was excellent in 21, good in 10 cases, fair in 3 cases and poor in 1 case, and the functional score was excellent in 0 cases, good in 13 cases, fair in 18 cases and poor in 4 case. The most common complications were pin tract infection (n=25), delayed union (n=6) and axial deviation (n=4). There were significant differences in bone lengthening index, mineralization index and EFI between single level and double level bone transport. Conclusion: Femoral defect caused by chronic osteomyelitis can be treated effectively using single and double level bone transport technique. Double level bone transport can significantly shorten the external fixator time, and there is no significant difference in the incidence of complications between single and double level bone transport.