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Spontaneous healing of a 14 cm diaphyseal cortical defect of the tibia

2003; Elsevier BV; Volume: 34; Issue: 5 Linguagem: Inglês

10.1016/s0020-1383(02)00026-8

1879-0267

A. Hinsche, P.V. Giannoudis, S. J. Matthews, R. M. Smith,

Orthopaedic implants and arthroplasty

Post–traumatic bone defects present a difficult treatment problem for the orthopaedic trauma surgeon but modern techniques have made segmental reconstruction feasible. Experiences with the Ilizarov technique [ [1] Aronson J. Johnson E. Harp J.H. Local bone transport for treatment of intercalary defects by the Ilizarov technique: biomechanical and clinical considerations. Clin. Orthop. 1989; 243: 71-79 PubMed Google Scholar ] and bone segment transport over unreamed intramedullary nails [ 2 Carrington N.C. Smith R.M. Knight S.L. Matthews S.J.E. Ilizarov bone transport over a primary tibial nail and free flap: A new technique for treating Gustilo grade 3b fractures with large segmental defects. Injury. 2000; 31: 112-115 Abstract Full Text Full Text PDF PubMed Scopus (23) Google Scholar , 3 Raschke M.J. Mann J.W. Oedekoven G. Claudi B.F. Segmental transport after unreamed intramedullary nailing: preliminary report of a “Monorail” system. Clin. Orthop. 1992; 282: 233-240 PubMed Google Scholar ] have produced good results in the management of large diaphyseal cortical defects. Alternative treatment options include massive autologous bone grafting, free vascularised fibula transfer as well as tibiofibular synostosis [ 4 Campanacci M. Zanoli S. Double tibiofibular synostosis (fibula pro tibia) for non-union and delayed union of the tibia. J. Bone Jt. Surg. 1996; 48A: 44-56 Google Scholar , 5 Enneking W.F. Eady J.L. Burchardt H. Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J. Bone Jt. Surg. 1980; 62A: 1039-1058 Google Scholar , 6 Newington D.P. Sykes P.J. The versatility of the free fibula flap in the management of traumatic long bone defects. Injury. 1991; 22: 275-281 Abstract Full Text PDF PubMed Scopus (30) Google Scholar ]. Spontaneous healing of bone defects and hypertrophic callus formation have been described when associated with head injury [ [7] Klein D.M. Caligiuri D.A. Riina J. Katzman B.M. Spontaneous healing of a massive tibial cortical defect. J. Orthop. Trauma. 1997; 11: 133-135 Crossref PubMed Scopus (13) Google Scholar ] as well as in children [ [8] Cappendijk V.C. van de Ven K.P. Madern G.C. Haverlag R. et al. Strength of youth: conservative treatment of segmental bone defect in children. J. Trauma. 2000; 49: 1123-1125 Crossref PubMed Scopus (6) Google Scholar ] but in the literature we did not find any case similar to the here presented.