title: Multistaged surgical management of posttraumatic segmental tibial bone loss.
abstract: Fracture nonunions associated with segmental diaphyseal bone loss challenge present methods of sustaining bone length and securing bony union. In the tibia, single-stage grafting procedures to accomplish this reconstruction requires major tissue sacrifice from adjacent areas and often results in amputation. A series of nine patients with tibial segmental diaphyseal bone loss were treated with multistaged surgical reconstruction. All nine were patients with severe trauma, with soft-tissue loss and local sepsis, who were candidates for amputation. The follow-up period averaged 5.5 years. All of the patients achieved healed, stable legs. All but one were fully ambulatory without a brace eight to 15 months after the first stage of bone grafting. There were several minor complications, which were satisfactorily treated. Multistaged bone graft operations were relatively low-risk, with a high incidence of success for treatment of major tibial segmental bone loss.
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation; D005597:Fractures, Open / Q000601:surgery*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D016038:Skin Transplantation; D013978:Tibial Fractures / Q000601:surgery*; D014946:Wound Infection / Q000517:prevention & control