Bone Transport Using a Circular Frame Construct Over a Locking Plate for Femoral Non-Union: A Case Report

Zayzan KR1, Atan AA2*, Ab Rahman Z2, Bahaudin N2 and Ahmad AR2

1Department of Orthopedics, Hospital Sungai Buloh, Malaysia
2Department of Orthopedics, Hospital Tuanku Ja’afar Seremban, Malaysia

^*Correspondance to: Ahmad Arieff Atan 

 PDF  Full Text DOI: 10.25107/2474-1647.3523

Abstract

Non-union poses great challenges for both the patient and the attending surgeon. Apart from the physiological burden of the condition towards bone healing, the psychosocial effect on the patient should be paid attention to, especially if a lengthy treatment period and multiple surgeries are needed to address the issue. A 36 years old patient presented with aseptic non-union of his left femur six months after he underwent plating for the closed comminuted fracture of the left femur. Clinical, laboratory and radiological investigations confirmed the absence of infection. There was a significant bony gap despite the presence of multiple small bony fragments over the distal third diaphysis of the left femur seen on the radiographs. The patient subsequently underwent application of a circular frame and corticotomy meant for bone transport, with retainment of the previous plate. The transport was commenced for 8 weeks, followed by an additional two weeks of turning to further compress the docking site. At 5 months after the surgery, the circular frame was removed with radiological evidence of union seen and good quality of bone regenerate. The patient recovered with excellent radiological and functional outcomes. The treatment of aseptic non-union with large bone defect using bone transport by circular frame over a plate is a viable option. Apart from producing quality bone regenerate to fill up the defect, the reduced time-on-frame and avoiding mismatch or malalignment minimizing the need for docking site procedure to achieve union. These help to achieve excellent radiological and functional outcomes for patients who may benefit from such method.

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Cite the article

Zayzan KR, Atan AA, Ab Rahman Z, Bahaudin N, Ahmad AR. Bone Transport Using a Circular Frame Construct Over a Locking Plate for Femoral Non-Union: A Case Report. Clin Surg. 2022; 7: 3523..