ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024
The management of critical bone defects: outcomes of a systematic approach.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- Lyophilized apoptotic vesicles improve hemostasis and bone regeneration in traumatic patients with impacted third molar extraction.Molecular therapy : the journal of the American Society of Gene Therapy · 2025Trial
- Human BMP4 mRNA Encapsulated in Lipid Nanoparticle for Bone and Articular Cartilage Repair in Aged Mice.Journal of functional biomaterials · 2026Article
- Multifunctional implantable hydrogels: Smart platforms at the forefront of biomedical innovation.Materials today. Bio · 2026Review
- Surgical limb-sparing in veterinary medicine: A review of existing techniques in dogs.Veterinary surgery : VS · 2026Review
- Clinical outcomes and feasibility of 3D-printed titanium alloy scaffolds combined with platelet-rich plasma injection in the treatment of long-segment femoral defects.BMC research notes · 2026Article
- Bone transport in the management of fracture-related infection: current concepts and innovations.Journal of bone and joint infection · 2026Review
- How Emerging Nanomaterials are Effective in Bone Regeneration?International journal of nanomedicine · 2026Review
- Developing Multimodal Cu-TCP@PCL Periosteal Patch with Modulated Morphogenesis and Osteogenic Enhancement for Bone Tissue-Engineering Application.International journal of nanomedicine · 2026Article
- Preliminary Preclinical Evaluation of Innovative Bone Scaffolds Composed of Natural Sources-Whey Protein Isolate and Pearl Powder.International journal of molecular sciences · 2025Article
- Effectiveness of the induced membrane technique in aseptic and infected long-bone defect management: Are there any differences?World journal of orthopedics · 2025Review
- Letter to the editor regarding "the management of critical bone defects: outcomes of a systematic approach".European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Advancing Nanomedicine: For Bone Defect Repair and Regeneration.International journal of nanomedicine · 2025Review
- Optimizing bone transport strategies: a pixel value ratio-based evaluation of regeneration rates in bifocal and trifocal techniques.Frontiers in surgery · 2024Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe reconstruction of segmental long bone defects remains one of 'The holy grails of orthopaedics'. The optimal treatment of which remains a topic of great debate. This study aimed to evaluate the outcomes following the management of critical-sized bone defects using a classification-based treatment algorithm.
methodsA retrospective review of all patients undergoing treatment for segmental diaphyseal defects of long bones at a tertiary-level limb reconstruction unit between January 2016 and December 2021, was performed. The management of the bone defect was standardised as per the classification by Ferreira and Tanwar (2020).
resultsA total of 96 patients (mean age 39.8, SD 15.2) with a minimum six months follow-up were included. Most bone defects were the result of open fractures (75/96) with 67% associated with Gustilo-Anderson IIIB injuries. There was a statistical difference in the likelihood of union between treatment strategies with more than 90% of cases undergoing acute shortening and bone transport achieving union and only 72% of cases undergoing the induced membrane technique consolidating (p = 0.049). Of those defects that consolidated, there was no difference in the time to bone union between strategies (p = 0.308) with an overall median time to union 8.33 months (95% CI 7.4 - 9.2 months). The induced membrane technique was associated with a 40% risk of sepsis.
conclusionThis study reported the outcomes of a standardised approach to the management of critical-sized bone defects. Whilst overall results were supportive of this approach, the outcomes associated with the induced membrane technique require further refinement of its indications in the management of critical-sized bone defects. LEVEL OF EVIDENCE: 4:
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