Bone defects in the lower extremities induce substantial burden for patients with trauma, infection or malignancy. A critical bone defect is a void that will not fill without an intervention. Generally, a circumferential loss of greater than 50% or a defect that is longer than 2 cm is considered critical in adult patients. However, these parameters are substantially influenced by individual components or factors related to the patient. These individual factors are compliance, adequate nutritional status, no smoking, no infection, absence of comorbidities, such as diabetes or hormone diseases (thyroid), corticosteroids and good soft tissue coverage. Hence, to start any therapeutic planning, a thorough analysis is critical in all patients with a lower extremity bone defect.
How to perform this initial assessment and all the critical diagnostic steps will be highlighted by Dr. Thierry Fabre during the upcoming webinar on the management of lower extremity bone defects, which will be broadcast live from the office of the French Society of Orthopaedic Surgery and Traumatology or SOFCOT the morning of 7 October 2017.
Dr. Fabre is one of the most recognized orthopaedic surgeons in this area. He will demonstrate the diagnostic steps and present all the information required for detailed planning. To fill these critical bone defects, bone segment transport is one of the sophisticated methods to fill in the defect with sufficient biomechanically stable bone. Several techniques were developed for this purpose, such as using an Ilizarov device, monorail external fixators and intramedullary nails. Prof. Frank Plasschaert will then present the perils and pitfalls of each technique.
After that, Dr. Jean Charles Auregan will discuss the standard autologous bone grafting technique for smaller defects of less than 5 cm. Moreover, he will present further biological techniques, such as vascularized bone transfer and the induced membrane technique (Masquelet). Especially in this field, new surgical techniques were developed which will be presented in a comprehensive manner. If these biological techniques fail, several artificial bone substitutes were developed during the recent decade that can be used. Prof. Peter Biberthaler will present a clear structured pathway through these innovative artificial bone defect fillers by giving an overview of the various materials and presenting the most recent data and results, as well as provide tips and tricks for surgical techniques.
After the presentations, there will be an online discussion with the faculty which will allow the webinar participants to ask questions to every presenter.
This webinar compiles the most critical information about bone defect therapy in lower extremities in a clear structured and comprehensive manner, independent of any influence from the implant manufacturers. It is a joint venture project of the SOFCOT and EFORT e-learning group, which has gathered European experts in the field to provide a comprehensive, condensed overview of the topic, from the gold standard treatment through innovative future solutions. Stay tuned for further details on how to participate in the webinar and access the broadcast.
- Mauffrey C, et al. J Am Acad Orthop Surg. 2015;doi:10.5435/JAAOS-D-14-00018.
- For more information:
- Webinar to be held Saturday 7 October 2017 10:00-11:30 CET
- Broadcast live from the SOFCOT; Register now.
- Faculty: Thierry Fabre; Frank Plasschaert; Jean Charles Auregan; and Peter Biberthaler