Cable-asisted bone transport versus circular external fixators-asisted bone transport in the management of bone defects of the Tibia: clinical and imaging results.

IF 2.8 3区医学 Q1 ORTHOPEDICS Journal of Orthopaedic Surgery and Research Pub Date : 2025-03-12 DOI:10.1186/s13018-025-05648-9

Güngör Alibakan, Muharrem Kanar, Raffi Armağan, Yusuf Sülek, Yusuf Altuntaş, Osman Tuğrul Eren

{"title":"Cable-asisted bone transport versus circular external fixators-asisted bone transport in the management of bone defects of the Tibia: clinical and imaging results.","authors":"Güngör Alibakan, Muharrem Kanar, Raffi Armağan, Yusuf Sülek, Yusuf Altuntaş, Osman Tuğrul Eren","doi":"10.1186/s13018-025-05648-9","DOIUrl":null,"url":null,"abstract":"Purpose: The aim of this study was to compare the efficacy, clinical outcomes, and complications of cable-asisted bone transport (CASt) and circular external fixator-assisted bone transport (CEFt) methods in the management of bone defects of the tibia.Methods: A retrospective analysis was conducted on 32 patients who underwent segmental bone transport for tibial bone defects between January 2006 and January 2020 and met the study inclusion criteria. Patients were categorized into two groups: CASt group (n = 16) and CEFt group (n = 16). The primary outcome measures included radiological parameters (External Fixator Index (EFI), Radiological Consolidation Time (RCT), and Radiological Consolidation Index (RCI)), functional independence (Lower Extremity Functional Index, LEFI) and functional outcomes (ASAMI Bone and Functional Scores). Secondary outcomes included pain levels (Visual Analog Scale, VAS), and complication rates (Paley's and Checketts-Otterburn classifications).Results: The CASt method resulted in significantly reduced pain scores during distraction (VAS: 4.81 ± 0.98 vs. 6.75 ± 0.86; p = 0.001). Pin-tract infection rates were significantly lower in the CASt group compared to the CEFt group (50% vs. 93.8%; p = 0.013). There was no significant difference between the groups in radiological (EFI, RCT, RCI) and functional outcomes (ASAMI scores) (p > 0.05).Conclusion: Both CASt and CEFt methods are effective and reliable options in the management of bone defects of the tibia. However, CASt offers advantages such as lower pin-tract infection rates and less pain during distraction, resulting in greater patient comfort and compliance. Given its less invasive nature, CASt may be preferable in patients at higher risk of infection or with a low pain threshold. However, the technical complexity of this method requires experienced surgical application.","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"20 1","pages":"264"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899003/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Surgery and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13018-025-05648-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: The aim of this study was to compare the efficacy, clinical outcomes, and complications of cable-asisted bone transport (CASt) and circular external fixator-assisted bone transport (CEFt) methods in the management of bone defects of the tibia.

Methods: A retrospective analysis was conducted on 32 patients who underwent segmental bone transport for tibial bone defects between January 2006 and January 2020 and met the study inclusion criteria. Patients were categorized into two groups: CASt group (n = 16) and CEFt group (n = 16). The primary outcome measures included radiological parameters (External Fixator Index (EFI), Radiological Consolidation Time (RCT), and Radiological Consolidation Index (RCI)), functional independence (Lower Extremity Functional Index, LEFI) and functional outcomes (ASAMI Bone and Functional Scores). Secondary outcomes included pain levels (Visual Analog Scale, VAS), and complication rates (Paley's and Checketts-Otterburn classifications).

Results: The CASt method resulted in significantly reduced pain scores during distraction (VAS: 4.81 ± 0.98 vs. 6.75 ± 0.86; p = 0.001). Pin-tract infection rates were significantly lower in the CASt group compared to the CEFt group (50% vs. 93.8%; p = 0.013). There was no significant difference between the groups in radiological (EFI, RCT, RCI) and functional outcomes (ASAMI scores) (p > 0.05).

Conclusion: Both CASt and CEFt methods are effective and reliable options in the management of bone defects of the tibia. However, CASt offers advantages such as lower pin-tract infection rates and less pain during distraction, resulting in greater patient comfort and compliance. Given its less invasive nature, CASt may be preferable in patients at higher risk of infection or with a low pain threshold. However, the technical complexity of this method requires experienced surgical application.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

在治疗胫骨骨缺损时，电缆辅助骨搬运与环形外固定器辅助骨搬运的临床和成像结果。

目的：本研究的目的是比较电缆辅助骨运输（CASt）和圆形外固定架辅助骨运输（CEFt）方法治疗胫骨骨缺损的疗效、临床结果和并发症。方法：回顾性分析2006年1月至2020年1月32例符合研究纳入标准的胫骨骨缺损行节段性骨转运的患者。患者分为两组：CASt组（n = 16）和CEFt组（n = 16）。主要结局指标包括放射学参数（外固定器指数（EFI）、放射学巩固时间（RCT）和放射学巩固指数（RCI））、功能独立性（下肢功能指数，LEFI）和功能结局（ASAMI骨和功能评分）。次要结果包括疼痛水平（视觉模拟量表，VAS）和并发症发生率（Paley's和Checketts-Otterburn分类）。结果：CASt法显著降低了牵张时疼痛评分(VAS: 4.81±0.98 vs. 6.75±0.86；p = 0.001)。与CEFt组相比，CASt组的针道感染率显著降低(50% vs. 93.8%；p = 0.013)。两组间放射学（EFI、RCT、RCI）和功能预后（ASAMI评分）差异无统计学意义（p < 0.05）。结论：CASt和CEFt是治疗胫骨骨缺损有效、可靠的方法。然而，CASt具有诸如较低的针道感染率和分散时较少的疼痛等优势，从而提高患者的舒适度和依从性。鉴于其侵入性较小，CASt可能更适合感染风险较高或疼痛阈值较低的患者。然而，这种方法的技术复杂性需要有经验的外科应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Journal of Orthopaedic Surgery and Research ORTHOPEDICS-

CiteScore

4.10

自引率

7.70%

发文量

494

审稿时长

>12 weeks

期刊介绍： Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues. Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications. JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.