Use of Universal Mini External Fixator in the Management of Postosteomyelitic Defects in Short Tubular Bones in the Paediatric Population

Abstract

Background/Purpose: The purpose of this study was to evaluate the results of reconstruction of postosteomyelitic defects in short tubular bones in a paediatric population using a universal mini external fixator (UMEX). Methods: This was a prospective case series based on 10 consecutive cases who were followed-up for an average period of 3.5 years. Ten patients (mean age: 10.2 years) with an average shortening of 4 cm of the corresponding digit were operated upon using soft tissue distraction by UMEX followed by interposition bone grafting from the iliac crest. The second metacarpal was involved in five patients, the first metacarpal in three patients, and the proximal phalanx of the right big toe was involved in two patients. Results: All of the patients achieved union at the graft host site at an average of 12 weeks and an average of 3.8 cm lengthening of the digit was achieved. All patients had improved digit length, and function and appearance of the hand and toe. Apart from a minor pin tract infection and stiffness, there were no major complications. Final average follow-up at 3.5 years did not show any recurrence of infection or loss of correction. Conclusion: We believe that UMEX is a versatile method of managing postosteomyelitic defects in short tubular bones, with fewer complications and a high union rate, even in situations in which bone fragments are small and difficult to handle with other methods.

Keywords

• osteomyelitis
• short tubular defects
• UMEX (Universal Mini external fixator)