The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: A retrospective cohort pilot study

Context: In patients with large bone defects, the method of bone transport remains one of the most adopted surgical techniques. Nonunion at the docking site is a critical complication of bone transport procedures. Aims: This study aimed to explore the impact of bone grafting at the docking site as w...

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Main Authors: Hasan Nahouli, Karim Masrouha, Rima Abdul-Khalek, Asdghig Der-Boghossian, Ali Rteil, Wassim Mourad, Said Saghieh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2020-01-01
Series:Journal of Limb Lengthening & Reconstruction
Subjects:
Online Access:http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2020;volume=6;issue=1;spage=33;epage=39;aulast=Nahouli
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author Hasan Nahouli
Karim Masrouha
Rima Abdul-Khalek
Asdghig Der-Boghossian
Ali Rteil
Wassim Mourad
Said Saghieh
author_facet Hasan Nahouli
Karim Masrouha
Rima Abdul-Khalek
Asdghig Der-Boghossian
Ali Rteil
Wassim Mourad
Said Saghieh
author_sort Hasan Nahouli
collection DOAJ
description Context: In patients with large bone defects, the method of bone transport remains one of the most adopted surgical techniques. Nonunion at the docking site is a critical complication of bone transport procedures. Aims: This study aimed to explore the impact of bone grafting at the docking site as well as radiographic parameters on union rates in patients who underwent bone transport for segmental bone defects of the tibia or femur. Settings and Design: This is a retrospective cohort of a consecutive series of adult patients treated with bone transport by a single surgeon at a single academic medical center. Subjects and Methods: Baseline characteristics of patients, bone transport procedure data, radiographic alignment data, and outcomes of those with bone grafting at the docking site were compared to those that did not. Statistical Analysis Used: Wilcoxon–Mann–Whitney U and Fisher's exact tests were used to analyze the study's data. Results: Thirty-two patients were included. Ten of 11 patients with bone graft at the docking site achieved union. Fifteen of 21 patients with no graft achieved union. Of the group that underwent bone transport without grafting, better alignment in the sagittal plane was significantly associated with achieving union (P = 0.026). The distraction gap of those that went on to unite (m = 9.33) was smaller than those that developed nonunion (m = 15.17) (P = 0.051). Conclusion: Although statistically insignificant, grafting of the docking site seemed to decrease the occurrence of nonunion at the clinical level. Higher distraction gap and translation in the sagittal plane may be the best predictors for nonunion of the docking site among nongrafted patients.
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spelling doaj.art-c0955d6ce9584db7ab6c827934339bf72022-12-22T00:20:19ZengWolters Kluwer Medknow PublicationsJournal of Limb Lengthening & Reconstruction2455-37192455-37192020-01-0161333910.4103/jllr.jllr_8_20The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: A retrospective cohort pilot studyHasan NahouliKarim MasrouhaRima Abdul-KhalekAsdghig Der-BoghossianAli RteilWassim MouradSaid SaghiehContext: In patients with large bone defects, the method of bone transport remains one of the most adopted surgical techniques. Nonunion at the docking site is a critical complication of bone transport procedures. Aims: This study aimed to explore the impact of bone grafting at the docking site as well as radiographic parameters on union rates in patients who underwent bone transport for segmental bone defects of the tibia or femur. Settings and Design: This is a retrospective cohort of a consecutive series of adult patients treated with bone transport by a single surgeon at a single academic medical center. Subjects and Methods: Baseline characteristics of patients, bone transport procedure data, radiographic alignment data, and outcomes of those with bone grafting at the docking site were compared to those that did not. Statistical Analysis Used: Wilcoxon–Mann–Whitney U and Fisher's exact tests were used to analyze the study's data. Results: Thirty-two patients were included. Ten of 11 patients with bone graft at the docking site achieved union. Fifteen of 21 patients with no graft achieved union. Of the group that underwent bone transport without grafting, better alignment in the sagittal plane was significantly associated with achieving union (P = 0.026). The distraction gap of those that went on to unite (m = 9.33) was smaller than those that developed nonunion (m = 15.17) (P = 0.051). Conclusion: Although statistically insignificant, grafting of the docking site seemed to decrease the occurrence of nonunion at the clinical level. Higher distraction gap and translation in the sagittal plane may be the best predictors for nonunion of the docking site among nongrafted patients.http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2020;volume=6;issue=1;spage=33;epage=39;aulast=Nahoulibone graftbone transportsegmental bone defectunion
spellingShingle Hasan Nahouli
Karim Masrouha
Rima Abdul-Khalek
Asdghig Der-Boghossian
Ali Rteil
Wassim Mourad
Said Saghieh
The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: A retrospective cohort pilot study
Journal of Limb Lengthening & Reconstruction
bone graft
bone transport
segmental bone defect
union
title The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: A retrospective cohort pilot study
title_full The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: A retrospective cohort pilot study
title_fullStr The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: A retrospective cohort pilot study
title_full_unstemmed The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: A retrospective cohort pilot study
title_short The impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur: A retrospective cohort pilot study
title_sort impact of radiographic parameters and bone grafting at the docking site on union following bone transport for segmental bone defects of the tibia and the femur a retrospective cohort pilot study
topic bone graft
bone transport
segmental bone defect
union
url http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2020;volume=6;issue=1;spage=33;epage=39;aulast=Nahouli
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