Schmidt J, Schmidt I, Winker H, Merk H, Ekkernkamp A
Unfallchirurgie, HELIOS Klinikum Berlin-Buch, Berlin.
Z Orthop Unfall. 2008 Jul-Aug;146(4):498-506. doi: 10.1055/s-2008-1038582.
Extremity conserving treatment in hospitals of maximum care involves a combination of soft tissue replacement and segment transfer. In contrast some other countries favour the segment transfer without soft tissue replacement and can demonstrate good results. Thus, we posed the question of the effects of soft tissue defects in callus distraction.
In an experimental study with two groups of sheep, a standardized fracture model in one group with bone and soft tissue defects and in the other group without soft tissue defects was compared. At specific dates the animals were euthanized and the bone quality combined with different soft tissue conditions were quantified.
At the outset of callus maturation, animals without soft tissue defects have a lead over animals with soft tissue defects. At the end of the experimental study both groups show the same bone quality results compared to a healthy comparison group.
At the terminal phase of the animal experiment the results of open segment transfer show no differences between the groups with or without soft tissue defects. This supports the experience of other countries. Because of the experimental set-up we cannot make any prediction regarding the biomechanical stability of the callus.
