Reconstruction of Post-Traumatic Bone Loss (BL) Members: Our Experience about 27 Cases

The purpose of this study is to evaluate our results of treatment of post-traumatic bone defect of members through various bone reconstruction techniques. Patients and method: It is a retrospective study continues from January 2008 to December 2012. It involved 27 patients who had bone loss following trauma members. The average age of patients was 36.2 years. We noted a male predominance (22 men). The causes of injuries were dominated by accidents of public roads (12 cases) and ballistic trauma (14 cases). We noted one case of work accident. The BL was localized in 10 cases the tibia, femur in 4 cases, 8 cases in the humerus, 2 cases in the fibula, 1 case was located in the olecranon, 1 case at the distal radius and 1 case to the ball. All lesions were open fractures. After a mean of support for 3 days, we performed emergency around 19 associated with internal fixation (10 cases external fixation, internal fixation 9 cases), 8 single around. Bone reconstruction was performed secondarily in the majority of cases (24 cases). Only 4 reconstructions were performed in emergency. Reconstruction techniques were dominated by conventional grafts (24 cases) associated or not with the technique of induced membrane. Bone reconstruction techniques we used were as follows: 24 cases of traditional autografts and 3 cases of intertibio-fibular graft. After an average decline of 43.6 months, our patients were evaluated clinically (axis and limb length) and radiological (bone healing). Results: bone healing was achieved in 22 cases after a mean of 3.8 surgeries and an average of 14.8 months. Conclusion: the main principles governing the reconstruction of a defect are pre healing associated infection and repair soft tissue whenever it can do. The current trend is to hybridization of the reconstruction process of the great losses of substance by developing strategies based on both the deliberate shortening.