Galilee Medical Center Expirience with Cable Bone Transport

Pavel Nudelman Halil Nasralla Einal Bathish Haim Shtarker
Orthopaedics A, Galilee Medical Center, Nahariya, Israel

Background: Restoration of bone defects is still one of the problems in orthopedic reconstruction. A more secure method for restoration is using external fixation devices for bone transport. Many different techniques were introduced in the past 30 years: acute shortening of limbs with future lengthening, bone transport with KW in different combinations, bone transport with half pins. The traditional segment transport method causes soft tissue problems relating to cutting of the skin by wires and stability of the transported segment.

Material and Methods: In order to limit such problems, in last 2 years we have started to use cable bone transport. Four patients with severe bone defects (one femur and three tibias) were treated with this method. The patients included three men and one women ranged in age from 14 to 30 years of age, with an average age of 23 years old. All patients suffered from severe traumatic injuries, in three cases, the defect was a result of a war trauma, and in one case, a severe post-traumatic bone loss due to a fall from height. We used the TL-Hex ring, ExFix adding to the frame a custom-made pulling system with a 1.8 mm cable which was passed through the bone.

Result: In all 4 cases, successive bone transport was achieved with good bone regeneration and avoidance of any skin problems during transport. The device was very well tolerated by patients and was easy for the patient to perform transport himself. The system was used in very complicated cases; no complications were noted.