Abstract：Objective To investigate the relevant factors of transporting bone segment (TBS) retraction after external fixation removal before the union of the docking site in the treatment of tibial defect by bone transport.Methods A retrospective analysis was conducted on 41 cases with tibial bone defect who were treated by bone transport in our hospital and presented TBS retraction after the removal or failure of external fixation before the union of the docking site. The patients included 25 males and 16 females aged 18-71 (40±15) years. Pearson correlation was used to analyze the relationship between TBS retraction distance and nine indexes, namely, age, gender, time from injury to operation, bone defect length, number of operations, TBS size, transport distance, fixation time, and time interval between radiologic examinations before and after the removal or failure of external TBS fixation. Risk factors with significant level were further identified using multivariate linear regression.Results The time from injury to operation was 7-95 (40.54±25.65) days, the bone defect length was 5.0-11.0 (6.90±1.20) cm, the number of operations was 1-5 (1.64±0.82), the TBS size was 4.8-12.0 (9.68±2.24) cm, the transport distance was 4.5-11.0 (6.76±1.64) cm, the fixation time was 3.5-11.5 (7.47±1.94) months, the time interval was 5-21 (10.16±4.07) days, and the retraction distance was 1.5-30.0 (8.73±7.99) mm. Pearson correlation showed that fixation time was negatively correlated with retraction distance, whereas transport distance and TBS size were positively correlated with transport distance, and the differences were significant(r=-0.897, 0.501, 0.419; all P values＜0.05). Differences in age, gender, time from injury to operation, bone defect length, and number of operations were not significant (all P values＞0.05). The multivariate linear regression analysis of fixation time, transport distance, and TBS size showed that transport distance and fixation time were linear with retraction distance (t=-10.385, 3.027; both P＜0.05), and the regression equation was: ＾Yretraction distance(mm)=27.081-2.805Xfixation time(month)+0.447Xtransport distance(cm) (R2=0.805, F=13.256, P＜0.01).Conclusions In the process of bone transport, the retraction distance is related to TBS size, transport distance, and fixation time, and fixation time and transport distance are linear with retraction distance.
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Zhou Zihong, Gu Sanjun, Sun Zhenzhong, Wei Changbao, Yin Qudong. Relevant factors analysis of transporting bone segment retraction after external fixation removal in the treatment of tibial defect by bone transport. Chinese Journal of Anatomy and Clinics, 2021, 26(6): 668-673.
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2021, Vol. 26 
