Exuberant callus formation after traumatic brain injury in femoral fractures with segmental bone defects: Two case reports and literature review

Abstract

Background: Segmental bone defects are defined as bone discontinuities with or without soft tissue defects, extending across the width of the bone. When this defect is 2–2.5 times larger than the diameter of the damaged bone, it is considered a critical segmental bone defect. What has been considered over the past 5 decades is that, based on clinical evidence, the presence of traumatic brain injury accelerates bone healing in patients with long-bone fractures. Method: Here, we report an exuberant callus formation in two cases who suffered from an open femoral shaft fracture with a segmental bone defect. The patients had a traumatic brain injury (TBI) at the scene of the accident and were treated with intramedullary nail (IMN) and masquelet procedures, respectively. Results: After 4 weeks the onset of the callus formation was noted and no additional procedure was needed. Conclusion: The segmental bone defect of the lower limb is one of the challenges of the orthopaedics. However, the faster healing process and callus formation of bone defects in TBI patients was impressive. In the same cases, using additional procedures due to enhance callus formation might not be necessary.

Keywords

• Segmental bone loss
• Traumatic brain injury
• Callus formation
• Femoral fracture