Management of large segmental tibial defects using a cylindrical mesh cage

Naftaly Attias, Ronald Lindsey

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

We report a case series of three patients who sustained open Gustilo-Anderson Type IIIB tibia fractures associated with extensive segmental bone and soft tissue loss. The patients initially were treated with serial wound irrigations, débridements, and external fixation. After the soft tissue envelope was reconstructed successfully, each large segmental bone defect was reconstructed with a cylindrical titanium mesh cage packed with a composite of cancellous allograft and demineralized bone matrix putty and stabilized with a statically locked intramedullary nail. The mean segmental bone loss was 12.2 cm, and all patients had a minimum 1-year followup. One year after reconstruction, radiographs showed stable, well-aligned, healed constructs, and computed tomography images verified the presence of bony ingrowth throughout the cages. All patients were able to ambulate with full weightbearing, and had good ipsilateral knee, hip, and ankle range of motion. This technique seems to be a reasonable alternative for treating large segmental tibial bone defects.

Original languageEnglish (US)
Pages (from-to)259-266
Number of pages8
JournalClinical Orthopaedics and Related Research
Issue number450
DOIs
StatePublished - Sep 2006

Fingerprint

Bone and Bones
Bone Matrix
Weight-Bearing
Articular Range of Motion
Nails
Titanium
Tibia
Ankle
Allografts
Hip
Knee
Tomography
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Management of large segmental tibial defects using a cylindrical mesh cage. / Attias, Naftaly; Lindsey, Ronald.

In: Clinical Orthopaedics and Related Research, No. 450, 09.2006, p. 259-266.

Research output: Contribution to journalArticle

@article{a805287629b843d1ba08d00208f708ed,
title = "Management of large segmental tibial defects using a cylindrical mesh cage",
abstract = "We report a case series of three patients who sustained open Gustilo-Anderson Type IIIB tibia fractures associated with extensive segmental bone and soft tissue loss. The patients initially were treated with serial wound irrigations, d{\'e}bridements, and external fixation. After the soft tissue envelope was reconstructed successfully, each large segmental bone defect was reconstructed with a cylindrical titanium mesh cage packed with a composite of cancellous allograft and demineralized bone matrix putty and stabilized with a statically locked intramedullary nail. The mean segmental bone loss was 12.2 cm, and all patients had a minimum 1-year followup. One year after reconstruction, radiographs showed stable, well-aligned, healed constructs, and computed tomography images verified the presence of bony ingrowth throughout the cages. All patients were able to ambulate with full weightbearing, and had good ipsilateral knee, hip, and ankle range of motion. This technique seems to be a reasonable alternative for treating large segmental tibial bone defects.",
author = "Naftaly Attias and Ronald Lindsey",
year = "2006",
month = "9",
doi = "10.1097/01.blo.0000223982.29208.a4",
language = "English (US)",
pages = "259--266",
journal = "Clinical Orthopaedics and Related Research",
issn = "0009-921X",
publisher = "Springer New York",
number = "450",

}

TY - JOUR

T1 - Management of large segmental tibial defects using a cylindrical mesh cage

AU - Attias, Naftaly

AU - Lindsey, Ronald

PY - 2006/9

Y1 - 2006/9

N2 - We report a case series of three patients who sustained open Gustilo-Anderson Type IIIB tibia fractures associated with extensive segmental bone and soft tissue loss. The patients initially were treated with serial wound irrigations, débridements, and external fixation. After the soft tissue envelope was reconstructed successfully, each large segmental bone defect was reconstructed with a cylindrical titanium mesh cage packed with a composite of cancellous allograft and demineralized bone matrix putty and stabilized with a statically locked intramedullary nail. The mean segmental bone loss was 12.2 cm, and all patients had a minimum 1-year followup. One year after reconstruction, radiographs showed stable, well-aligned, healed constructs, and computed tomography images verified the presence of bony ingrowth throughout the cages. All patients were able to ambulate with full weightbearing, and had good ipsilateral knee, hip, and ankle range of motion. This technique seems to be a reasonable alternative for treating large segmental tibial bone defects.

AB - We report a case series of three patients who sustained open Gustilo-Anderson Type IIIB tibia fractures associated with extensive segmental bone and soft tissue loss. The patients initially were treated with serial wound irrigations, débridements, and external fixation. After the soft tissue envelope was reconstructed successfully, each large segmental bone defect was reconstructed with a cylindrical titanium mesh cage packed with a composite of cancellous allograft and demineralized bone matrix putty and stabilized with a statically locked intramedullary nail. The mean segmental bone loss was 12.2 cm, and all patients had a minimum 1-year followup. One year after reconstruction, radiographs showed stable, well-aligned, healed constructs, and computed tomography images verified the presence of bony ingrowth throughout the cages. All patients were able to ambulate with full weightbearing, and had good ipsilateral knee, hip, and ankle range of motion. This technique seems to be a reasonable alternative for treating large segmental tibial bone defects.

UR - http://www.scopus.com/inward/record.url?scp=33748436518&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33748436518&partnerID=8YFLogxK

U2 - 10.1097/01.blo.0000223982.29208.a4

DO - 10.1097/01.blo.0000223982.29208.a4

M3 - Article

C2 - 16702918

AN - SCOPUS:33748436518

SP - 259

EP - 266

JO - Clinical Orthopaedics and Related Research

JF - Clinical Orthopaedics and Related Research

SN - 0009-921X

IS - 450

ER -