Is acute compression and distraction superior to segmental bone transport techniques in chronic tibial osteomyelitis ? Comparison of Distraction Osteogenesis Techniques

Abstract

Treatment of tibial osteomyelitis with infected, necrotic, unstable bone segments (Cierny-Mader Type IV local osteomyelitis) includes debridement and segmental resection, which results in long bone defects. Reconstruction may be with distraction osteogenesis. Segmental bone transport and acute compression and distraction techniques are two main distraction osteogenesis techniques used in the treatment of Type IV local tibial osteomyelitis. In this retrospective, four-center study we compared these two techniques during a 15-year period. 29 patients treated using segmental bone transport technique and 45 patients were treated using acute compression and distraction technique. The mean age (p=0,34) and the mean bone loss with preoperative shortening (P=0,08) and the mean number of previous operation (p=0,06) were not different in these two groups.. At latest followup, functional and radiographic results were evaluated There was no difference between two technique on the Paley's scoring system (p=0,33) and in the total number of complication(p=0,16). Mean external fixator index was lower in the second group (p=0.02). Both techniques can be used safely; however, the acute compression distraction technique may provide greater patient satisfaction because of shorter external fixator index, although future studies will be needed to determine whether this is.