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Objective: To demonstrate the outcome of tibial bone neo formation, using induced-membrane technique and nonvascularized ipsolateral fibular graft transposition. Case report: A 25 years old male with a 2 years ago firearm injury in left leg, presenting an initial diagnosis of open fracture Gustilo IIIB AO 42C3 IO4NV1MT2 with a 7cm tibial diaphyseal bone defect. During his hospital evolution multiple interventions were made including surgical debridement and skin grafts placement, with unfavorable results. Therefore, we decided to use the induced-membrane technique and nonvascularized ipsolateral fibular graft transposition, resulting in a cane dependent ambulation, in 4 months evolution after last intervention. Conclusion: Induced-membrane technique and non-vascularized ipsolateral fibular graft transposition could be a successful alternative for the management of patients with severe bone loss. [ABSTRACT FROM AUTHOR]

Introduction. The performing of osteogenesis by distraction in patients elder than their sixth decade of life is controversial and, up to the moment, the results have been scarcely satisfactory. Objective. To present our experience in femur bony transportation in a patient being in her sixth decade of life and suffering from a bony loss secondary to an atrophic septic pseudoarthritis. The Case Report. This study reports the case of a female patient of 52 years old having been diagnosed atrophic septic pseudoarthritis in the left femur, as well as a 12-centimeter bony loss. The treatment consisted of two surgical times, the first one of debridement and the second time of setting an Orthofix long elongator, besides the performing of a femoral osteotomy. The patient was subjected to a femoral transportation at a speed of 0.5 millimeters per day. When getting to the fragment transported to the distal femur, it was practiced the application of an autologous bony grafting. The time of the bony transportation was of 200 days. The corticalization and consolidation of the newly-shaped bone was obtained in a period of 600 days. During the treatment period, there were some complications, as follows: soft-part superficial infection and knee articular stiffness. These problems were solved through antibiotic therapy and knee physiotherapy. The total bony distraction that was obtained was of 12 centimeters. Conclusions. The obtained bony transportation allowed to achieve a proper functionality of the lower left member, and a length as long as the bony loss was obtained. The complications being present were solved during the treatment period. [ABSTRACT FROM AUTHOR]

Forearm bone loss is usually the result of high-energy trauma or complications or failures in managing simple fractures. Material and methods: a total of 38 patients were reviewed, with 44 lesions diagnosed as forearm bone loss resulting from nonunion, both aseptic and infected, where a Hunec nail was used as an implant and the defects were replaced with iliac crest fragments. The bones involved included 26 ulnas and 18 radii; they had been managed with previous surgical procedures, most of them with plates as implants. Infected cases were treated following the Colchero protocol. Iliac crest fragments were used to replace the bone defects ranging from 3 to 7.5 cm in length, with an average of 5.2 cm, and a Hunec nail was inserted as an implant. Results: the mean operative time was about 90 minutes. Except for 4 cases, all lesions healed within approximately 16 weeks. Combining an implant that provides optimum stability with a mean osteogenic supply rapidly integrating and geometrically adapting to the forearm bone shaft highlights the method advantages. [ABSTRACT FROM AUTHOR]

The bone losses in the forearm usually are result of injuries of high energy or to derive from complications or faults in the handling of simple fractures. A revision of patients with bone losses in forearm takes place derived from as much aseptic non-unions as infected, in which nail Hunec was used as it implants, replacing the defects with sections of iliac crest. One reviews a total of 38 patients with 44 injuries diagnosed like non-unions, 26 ulnars and 18 radius, all with previous surgical procedures in his majority handled with plates as implant. The infected cases were dealt with the protocol proposed by Colchero. In order to replace the 7.5 bone defects that went from 3 to cm with an average of 5.2 cm they used sections of iliac crest, and the Hunec nail was used as implants. A surgical time of approximately 90 minutes was had. Excepting four cases, all the injuries consolidated in an approximated period of 16 weeks. The advantages of the method when combining stand out implants that it provides optimal stability with means of osteogenics contribution of fast integration and geometric adaptation to the diaphisis of the bones of the forearm. [ABSTRACT FROM AUTHOR]