Bone Transport - Single Level Transport Case Study

Presenting

This 69 year old woman sustained a severe right open proximal tibia fracture with a vascular injury when she was pinned between 2 cars on a driveway. She was treated with serial débridements and a spanning external fixator with a vascular repair. Two weeks later she underwent soft tissue reconstruction and dual plating of her tibia by other physicians at an outside facility. She presented to our institution 8 months following her initial injury. At that time she had severe pain and no evidence of healing with bone missing from her proximal tibia.

Treatment in Progress

Dr. Brinker’s treatment included removal of all devitalized bone and hardware. The patient was then treated with Ilizarov bone transport from distal to proximal to reconstruct the proximal bony defect (red rectangle). The corticotomy site is marked with a red arrow.

Treatment in Progress

These x-rays show bone transport in progress with bone being moved from distal to proximal to reconstruct the upper bony defect.

Results After Treatment by Dr. Brinker

Final radiographs following Ilizarov removal and intramedullary nail fixation show solid healing of the entire length of the tibia. The patient is ambulating full weight bearing.