Zentrale Zugseilsysteme – vollautomatische, kontinuierliche Kallusdistraktion zur Behandlung langstreckiger Knochendefekte

Distraction osteogenesis involving bone transport enables the
reconstruction of large bone defects. The main bone fragments are
usually stablilised externally, an intermediate bone segment is
separated and moved through the defect at a rate of about 1 mm/day.
New high-quality bone is built up in the constantly enlarging
osteotomy gap. A major problem associated with the method is the
fact that the fixation pins are also moved over the same distance,
and cut through the soft tissue, often resulting in painful pin
tract infections and ugly scars. An automatic motorized bone
transport system employing a single central cable now eliminates
this problem. The system can be combined with any external
fixateur, since the relevant implanted parts for bone transport are
independent of the external stabilizer. The surgical procedure,
which is easy on the patient, consists of bone segment separation,
central cable fixation, and stabilisation of the main fragments,
and requires the use of numerous special tools. The distraction
itself results in significantly less soft tissue irritation and
pain. Pin tract infections are rare, so that changeover to internal
fixation after completion of bone transport carries little risk of
infection. This article details the technical features of the
stabilizing system and the transport and the control systems, and
describes the clinical application in a patient.