Management of Osseous Defects in the Tibia: Utilization of External Fixation, Distraction Osteogenesis, and Bone Transport

Abstract

The use of external fixators for distraction osteogenesis has revolutionized treatment options for segmental bone defects in the tibia. Following corticotomy, the latency phase allows the biologic environment to initiate healing, and optimized distraction rates produce regenerate. Regenerate consolidation can be improved with local and systemic biologic optimization. Consolidation time is often considered to be 3 to 4 times longer than distraction in adults. Soft tissue considerations are important during external fixation and distraction. Additionally, slow regenerate can be benefited by various techniques discussed in this article. Distraction osteogenesis is a beneficial tool for segmental bone defects.

Keywords: Bone transport; Corticotomy; Distraction osteogenesis; Regenerate; Segmental bone defects.