[Central cable system--fully automatic, continuous distraction osteogenesis for the lengthening treatment of large bone defects].
Distraction osteogenesis involving bone transport enables the reconstruction of large bone defects. The main bone fragments are usually stablilised externally, an intermediate bone segment is separated and moved through the defect at a rate of about 1 mm/day. New high-quality bone is built up in the constantly enlarging osteotomy gap. A major problem associated with the method is the fact that the fixation pins are also moved over the same distance, and cut through the soft tissue, often resulting in painful pin tract infections and ugly scars. An automatic motorized bone transport system employing a single central cable now eliminates this problem. The system can be combined with any external fixateur, since the relevant implanted parts for bone transport are independent of the external stabilizer. The surgical procedure, which is easy on the patient, consists of bone segment separation, central cable fixation, and stabilisation of the main fragments, and requires the use of numerous special tools. The distraction itself results in significantly less soft tissue irritation and pain. Pin tract infections are rare, so that changeover to internal fixation after completion of bone transport carries little risk of infection. This article details the technical features of the stabilizing system and the transport and the control systems, and describes the clinical application in a patient.
Baumgart
R
R
Klinikum der Universität München, Chirurgische Klinik und Poliklinik. Rainer.Baumgart@med.uni-muenchen.de
Hinterwimmer
S
S
Krammer
M
M
Mutschler
W
W
D000328:Adult; D004867:Equipment Design; D019544:Equipment Failure Analysis; D016267:External Fixators; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000295:instrumentation* / Q000379:methods; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome