Successful re-distraction osteogenesis on the consolidated bone resulted from previous distraction osteogenesis of tibia: A case report.

Treating massive tibial bone defects resulting from high-energy trauma are pose a significant challenge in the field of orthopaedic surgery. While several methods exist for addressing extensive bone defects, distraction osteogenesis (DO) recognized as one of good options. A 22-year-old male was referred to our orthopaedic clinic due to a wound infection and bone defect on right lower leg area. The patients previously treated with distraction osteogenesis (bone transport) by another surgeon. The patients stopped the distraction process and refuse further follow-up for 6 months. This resulted in consolidation of the distracted bone, however bone defect was still present by 7.5 cm and a skin defect. The patients received soft tissue coverage procedure with cross-leg flap which performed by the orthopaedic micro surgeon. After successful soft tissue coverage, the patient underwent re-osteotomy and another re-distraction osteogenesis procedure of tibia at the bone resulted from previous distraction osteogenesis. Good quality of callus was resulted after the procedure and finally closed all the bone defect. The total bone resulted from distraction osteogenesis was 23.5 cm. Good quality of bone regeneration could be expected with re-distraction osteogenesis on the consolidated bone resulted from previous distraction osteogenesis of tibia.