title: Bone transport over an intramedullary nail for reconstruction of long bone defects in tibia.
abstract: BACKGROUND
  Although long bone defects may be treated by callus distraction, frequent complications arise from the long duration of external fixation. To reduce such complications, bone transport over an intramedullary nail (BTON) has been done for tibial bone defect.
  
  
  METHODS
  In 12 patients (mean age, 46.1 years) of chronic osteomyelitis or bone defect, segmental transport was done using external fixator over an intramedullary nail. Prior to the index procedure, all patients had had serial debridements and five required myocutaneous or free flaps for covering of soft tissue defects. Using Mekhail's criteria, functional results were evaluated.
  
  
  RESULTS
  The mean transported amount was 5.9 (range, 3.5-12) cm. The mean external fixation index was 26 days/cm, and healing index was 62.6 days/cm. The primary union of distraction and docking site was achieved in all, except for one failure in union at the docking site, which required another bone graft. Except for one patient with associated ankle injury, all had excellent or good functions. There was one recurrence of osteomyelitis and one procurvatum of the proximal tibia of 10 degrees .
  
  
  CONCLUSIONS
  BTON may be a successful method in tibial reconstruction and allows patients to return to daily life earlier with relatively few complications.
authors.affiliation: Department of Orthopedic Surgery, Kyungpook National University Hospital, 50, Samdok, Chung-gu, Daegu 700-721, South Korea. cwoh@knu.ac.kr
authors.forename: Chang-Wug
authors.initials: CW
authors.lastname: Oh
authors.forename: Hae-Ryong
authors.initials: HR
authors.lastname: Song
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Roh
authors.forename: Jong-Keon
authors.initials: JK
authors.lastname: Oh
authors.forename: Woo-Kie
authors.initials: WK
authors.lastname: Min
authors.forename: Hee-Soo
authors.initials: HS
authors.lastname: Kyung
authors.forename: Joon-Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Poong-Taek
authors.initials: PT
authors.lastname: Kim
authors.forename: Joo-Chul
authors.initials: JC
authors.lastname: Ihn
mesh_terms: D000293:Adolescent; D000328:Adult; D001850:Bone Diseases, Infectious / Q000601:surgery*; D001852:Bone Lengthening / Q000379:methods*; D001858:Bone Nails; D016267:External Fixators; D006801:Humans; D008875:Middle Aged; D010019:Osteomyelitis / Q000601:surgery*; D012189:Retrospective Studies; D013977:Tibia; D055815:Young Adult