Mosaic External Fixation Of A Bone Lengthening Treatment Of Large Bone Defects Nonunion Clinical Research

Objective: To study the clinical effects of the inlaid unilateral external fixator and callus distraction in first-stage treating nonunion with segmental bone defect, and provide clinical evidence for application of unilateral external fixator.Method: Retrospective study of 43 cases of nonunion with segmental bone defect from October 2001 to April 2008. All cases, 24 male and 19 female, were treated with the inlaid unilateral external fixator and callus distraction, 3.4 to 57 years old with an average age of 31.8, among which 16 cases were of femur, 12 of tibia, 7 of shoulder bone, and 8 of ulna and radio. The length of bone defect was 3.5 to 26cm with an average of 7.8cm. We have evaluated the effect of treatment such as healing time, osteogenesis of the nonunion, limb functions, and speed of bone lengthening.Results: All patients were followed-up for 9 to 58 months with an average of 21.8 months after operation. 42 patients were healed, and the healing time was 6-33 months with an average of 14.13 months indicated in image. The earliest time for the affected limb to swing and load was 4 to 25 months with an average of 13.1 months. Time of removing the external fixator was 6 to 34 months with an average of 18 months. The healing-rate of nonunion was 90.7%, and the recovery rate of limb function was 96.7%. Bone lengthening speed was 29.5 to 42.6 days/cm with an average of 34.6 days/cm.Conclusion: Callus distraction using inlaid unilateral external fixator was an effective way of treating nonunion with segmental bone defect, which was indicated by healing time, osteogenesis of the nonunion, limb functions, and speed of bone lengthening.