ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2022
Management of post-traumatic femoral defects with a monorail external fixator over an intramedullary nail.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 10 citations in OpenAlex.
- Bone transport in the management of fracture-related infection: current concepts and innovations.Journal of bone and joint infection · 2026Review
- [Treatment of bony defects in femur and tibia : Established and new concepts].Unfallchirurgie (Heidelberg, Germany) · 2025Article
- Limb Reconstruction System for Infected Nonunion: A Retrospective Study.Journal of orthopaedic case reports · 2025Article
- Shortening/re-lengthening and nailing versus bone transport for the treatment of segmental femoral bone defects.Scientific reports · 2023Article
- Outcome analysis of ilizarov and monorail fixators in the treatment of nonunion of long bones: A systematic review and proportion meta-analysis.Journal of clinical orthopaedics and trauma · 2023Article
- A modified hybrid transport technique combined with a retrograde tibiotalocalcaneal arthrodesis nail for the management of distal tibial periarticular osteomyelitis and associated defects.Journal of orthopaedic surgery and research · 2023Article
- Long Bone Defect Filling with Bioactive Degradable 3D-Implant: Experimental Study.Biomimetics (Basel, Switzerland) · 2023Article
- New insights in lower limb reconstruction strategies.Therapeutic advances in musculoskeletal disease · 2023Review
- Management of femoral non-union with post-traumatic bone defect using second-generation PRECICE® nail - A case report.Trauma case reports · 2022Article
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe management of limb-length discrepancy secondary to traumatic femoral bone loss poses a unique challenge for surgeons. The Ilizarov technique is popular, but is associated with long external fixator time and many complications. This retrospective study assessed outcomes of post-traumatic femoral defects managed by monorail external fixation over an intramedullary nail.
methodsEight patients were included from October 2015 to May 2019 with post-traumatic femoral defects that underwent treatment with monorail fixator-assisted intramedullary nailing. Primary outcome was time to bone union and bone results according to ASAMI classification. Secondary outcomes were lengthening index, consolidation time and index, external fixator index (EFI), time to partial weight bearing(PWB) and full weight bearing (FWB), and complications. Patient reported outcome measures including EQ-5D-5L, SF-36, Oxford knee scores (OKS), and Oxford hip scores (OHS) were recorded after recovery.
resultsMean follow-up time was 227 weeks. Average bone defect size was 9.69 cm. Average consolidation time and index were 11.35 months and 1.24 months/cm, respectively. Mean lengthening and external fixator index were 20.2 days/cm and 23.88 days/cm, respectively. On average, patients achieved FWB and bone union 56.25 weeks and 68.83 weeks after bone transport initiation, respectively. Two patients had docking site non-union, five patients had pin site infections, and two patients had osteomyelitis. EQ-5D-5L and EQ-VAS scores were compared to UK population norms (p = 0.104, p = 0.238, respectively). Average OKS was 32.17 and OHS was 34.00.
conclusionMonorail external fixation over an intramedullary nail is an effective option for post-traumatic femoral defects, reducing external fixator time and returning patients' quality of life to a level comparable with the normal population.
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