Abstract: Background: Distraction osteogenesis is a method of producing unlimited quantities of living bone directly from a special osteotomy (cortico to my). Advances in methods of external fixation have made limb lengthening a feasible option achieved by distraction osteogenesis. Complex trauma cases such as failure of fractures to unite after several attempts, significant soft tissue infection, significant bone loss ab initio, the presence of significant soft tissue loss, or chronic osteomyelitis that may warrant significant bone resection are a nightmare to the surgeon the patient and the patients relations as well. The linear rail system and the Ilizarov device oppose other methods of bone gap management permits the realization of compression, distraction, bone-lengthening, and deformity correction, as such improving the quality of life of the patients, good fracture union with insignificant complications.
Methods: A hospital based retrospective study conducted at The Potters Specialist Hospital Jos between January 2018 and December 2020. Patients were recruited following a perusal of the operation register. A proforma was filled which included the patient’s demographics, clinical characteristics. Clinical outcomes during the treatment such union at fracture site, length gained and complications during treatment were included in the proforma. Patient’s quality of life after the treatment was also assessed. Data was analyzed using SPSS version 23.
Results: Thirty-six patients were enrolled into the study. Patients mean age was 39.36±10.64. Age group 31-40 accounted for 47.2% of those recruited. Males were 83.3% and complications of fracture management were noticed to account for 22 (61.1%) of the indications for surgery. Those who had two surgeries done during treatment were 27.8% with interval corticotomy counting as a separate surgery. Limb lengthening was done in 52.8% of the patients and the leg was found to be operated limb 75% of cases. Though 72.6% did not develop any problems, among those with problems, pin tract infection was noticed in 13.9%. Similarly, 88.9% had no complications but amongst complications noted limb length discrepancy in 5.6%. All of them had their fractures united and limb lengths equalized to an acceptable level. Regarding quality of life most patients (44.4%) rated it as good and the other 22.2% very good and when asked about the satisfaction their current health 50% said they were satisfied and another 19.4% were very satisfied.
There was significant association noticed between quality of life and indications for surgery, between complication and aim of surgery and noticed between complication and length gained.
Conclusion: The use of the linear rail system in the treatment of complex major limb fractures yielded satisfactory results with improved quality of life and less problems and complications.
