Management of tibial bone defects due to high energy trauma using the locally manufactured external fixator by segmental bone transport.

BACKGROUND Bone defect in long bones is a problem in orthopaedic which needs proper treatment to restore limb length and function of the limb. There are various treatment modalities available to fill the detect like bone grafting, vascularised bone graft, allograft and bone transport through fixators (Ring or Uniplanner). This study was done to determine the outcome of locally manufactured External Fixator (Naseer and Awais ) in the management of tibial bone defect due to trauma. METHODS This descriptive study was conducted on 20 patients in orthopedic department in Lady Reading Hospital Peshawar and Ayub Teaching Hospital Abbottabad, from Nov 1997 to Nov 2002. Patients from either gender aged between 20 to 50 years, having tibial bone defect of more than five centimeter due to trauma were included in the study. Follow up was done for two years. Outcome measures were adopted according to the classification of the Association for the Study and Application of the Method of llizarov (ASAMI) based on clinical (functional) and radiological findings (defect filling). RESULTS Out of 20 patients 14 (70%) were males and 6 (30%) were female patients. Right tibia was involved in 12 patients (60%) and left tibia in 8 patients (40%). Bony defects due to firearm injury were in 14 patients (70%) and road traffic accidents were in 6 patients (30%). Radiological (bony) results were excellent in 12 patients (60%), good in 2 patients (10%), fair in 3 patients (15%) and poor in 3 patients (15%). Clinical (functional) results were excellent in 7 patients (35%), good in 8 patients (40%), fair in 4 patients (20%,) and poor in 1 patients (5%,). Post operative complications after distraction osteogenesis were pin tract infections in 8 patients (40%), Axial deviations in 6 patients (30%), foot equinus in 4 patients (20%) and refracture in 1 patient (5%). CONCLUSION Uniplanner locally manufactured (NASEER & AWAIS) External Fixator for distraction osteogenesis is cheap, easy to apply and gives excellent and comparable results in tibial bone defects.