• Jayaramaraju Dheenadhayalan, Vasudeva Nagashree, Agraharam Devendra, Thirumurugan Jaganathan, and Shanmuganathan Rajasekaran.
• Department of Orthopaedics and Trauma, Ganga Medical Centre and Hospitals Pvt. Ltd, 313, Mettupalayam Road, Coimbatore, India. dheenu.dhayalan@gmail.com.
• Eur J Trauma Emerg Surg. 2023 Feb 1; 49 (1): 523530523-530.

IntroductionDistraction osteogenesis is a safe and reliable option for managing bone defects of the tibia following major open fractures. Even though the Limb Reconstruction System (LRS) is a popular option, it may result in malalignment, necessitating an additional procedure to correct the alignment. The objective of the study is to assess the efficacy of a novel surgical technique in minimising malalignment.MethodsThis was a retrospective cohort study conducted at a level 1 tertiary trauma centre consisting of 35 patients with primary bone loss following open tibia fractures. A uniplanar LRS frame was applied using a combined spacer rod with plate technique. Radiological assessment of docking site characteristics (translation, angulation) and functional assessment using ASAMI score was done.ResultsThe mean distraction regenerate length was 8.4 ± 3.45 cm. At the docking site, 18 patients did not have any deformity, 13 had a minor deformity of ≤ 5°, 2 had a moderate deformity of 6°-10° and 2 with a severe deformity > 10°. Circumferential docking was seen in 88.5% (31/35). According to the ASAMI functional scoring, 13 patients had excellent outcomes, 19 had good, one had fair, and two had poor outcomes. Six patients had pin tract infections, three had deep infections, and 17 had a delayed union. Our study had a lower incidence of malalignment compared to similar studies in the literature.ConclusionThe use of this simple and economical intra-operative technique allowed for much higher precision in aligning the fracture ends, thus minimising the docking site malalignment.Level Of EvidenceIII.Level Of Clinical CareLevel I Tertiary trauma centre.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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