Bone transport in the management of post-osteomyelitis femoral defects in children: A case series with a minimum of 10-year follow-up in Uganda

Abstract

Purpose: The aim of this study was to evaluate the long-term outcomes of the bone transport technique in the management of post-infectious segmental femoral bone defects in children in a low-income country. Methods: Eleven children were included in this case series. All had a femoral defect secondary to osteomyelitis managed with the internal bone transport technique using an external fixator alone. Bone and functional results were evaluated and complications recorded after a minimum follow-up period of 10 years (range: 10–16). Results: The mean age of the patients was 7.8 years, and the average size of the bone defect was 10.8 cm. At the latest follow-up, bone results were excellent in three, good in five, and fair in three, while the functional results were excellent in three, good in four, fair in three, and poor in one. Limb length discrepancy was observed in 10 cases while hip and/or knee joint disorder was recorded in six cases. At the last follow-up, only one patient had a recurrence of infection. Conclusion: The bone transport technique has proven to be a valid option for eradicating infection and filling large bone defects in children. However, it is a technically difficult and lengthy procedure that is prone to unique complications. Level of Evidence: IV-Case series