title: Segmental bone loss in pediatric lower extremity fractures: indications and results of bone transport.
abstract: BACKGROUND
  In this study, we evaluated the results of external bone transport, which was applied to 11 patients with traumatic bone loss who had not completed their bone development.
  
  
  METHODS
  The average age of the 9 male and 2 female patients was 10.6 (range, 8 to 16) years. Eight of the defects were located in the tibia, whereas the other 3 were in the femur. The average defect was 5.4 (range, 4.5 to 8.5) cm. External bone transport was applied in the early period in 7 patients, whereas in 4 patients it was performed due to nonunion. Bifocal osteosynthesis and single osteotomy were performed in 2 patients with type B2 nonunion. Compression to the nonunion region and lengthening in the osteotomy region were applied. In 2 patients with type B1 nonunion, and the other 9 patients who had external bone transport, the gap was eliminated by bifocal osteosynthesis, single osteotomy, and bone transport to the osteotomy line.
  
  
  RESULTS
  The mean follow-up period was 21 (range, 13 to 48) months. Complete union was achieved in all patients without any bone operation or graft application. No refracture was observed after the removal of the external fixator, and the average hospitalization time was 16 (range, 7 to 65) days. The average external fixation time was 4.2 (range, 3.5 to 5.5) months, and the mean external fixator index was 0.8 months (23 d/cm). The mean bone healing time was 5.1 (range, 4.6 to 6) months.
  
  
  CONCLUSIONS
  To initially consider the open fractures with true or in situ bone loss in children as "anticipated nonunion," and determine the treatment strategies regarding this fact, may prevent nonunion and shorten the healing period. Bone transport in the treatment of traumatic bone defects in children is an easy biological procedure, with lower complications but higher success ratios.
  
  
  METHODS
  Level IV-therapeutic.
authors: *Department of Orthopaedics and Traumatology, Dicle University Medical Faculty †Department of Orthopaedics and Traumatology, Diyarbakir Training and Educational Hospital, Diyarbakir, Turkey.
authors: Hüseyin
authors: H
authors: Arslan
authors: Emin
authors: E
authors: Özkul
authors: Mehmet
authors: M
authors: Gem
authors: Celil
authors: C
authors: Alemdar
authors: İlhami
authors: İ
authors: Şahin
authors: Bülent
authors: B
authors: Kişin
mesh_terms: D000293:Adolescent; D016025:Bone Transplantation / Q000379:methods*; D002648:Child; D003286:Contracture / Q000209:etiology / Q000517:prevention & control; D016267:External Fixators; D005260:Female; D005264:Femoral Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000601:surgery; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D019857:Osteogenesis, Distraction / Q000379:methods*; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011859:Radiography; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014421:Turkey; D014945:Wound Healing