Balanced cable bone transport of the tibia using automated motorized struts.

OBJECTIVE

Determine if automated struts can successfully power a balanced cable transport (BCT) during tibial bone transport and thus benefit from the advantages of automation.

DESIGN

Retrospective observational case series.

SETTING

Level 1 trauma center.

PATIENTS/

PARTICIPANTS

A retrospective analysis of 7 tibial BCTs using automated struts was performed with an average defect size of 102 mm.

OUTCOMES: Union rate, complications, external fixation index, bone healing index, and mechanical alignment.

RESULTS

The average bone healing index was found to be 21.9 days/cm in bifocal BCT and 13.7 days/cm in trifocal BCT. Automated struts successfully powered 7 BCTs but were not without complications. Four patients had strut malfunctions necessitating unscheduled return to clinic. Other complications not secondary to the struts included pin tract infections (n = 4) and unplanned return to the operating room (n = 2, docking site nonunion and revision ankle arthrodesis).

CONCLUSIONS

Automated struts powering BCT is feasible but not without complications. This treatment strategy combines the advantages of automation with the advantages of BCT. Incorporating automation into these complex constructs will allow for ease of use for patient and caregiver during the long process of bone transport, theoretically decrease noncompliance, which otherwise can cause severe complications, and increased segmentation, which may improve quality of regenerate bone formation.

LEVEL OF EVIDENCE: Level 4.