Objective: To assess the outcome of bifocal bone transport (trifocal distraction compression) for defective bone loss in tibia.
Methodology: This prospective study was conducted at department of orthopedic surgery, Dow University of Health Sciences/Civil Hospital, Karachi, Pakistan from 2000 to 2015. It included 15 patients with traumatic bone loss and infective nonunion with bone loss in tibia. Patients with bone loss in tumors were excluded from the study.
Results: Out of 15 patients, 12 were male and 3 female. Bone loss was 12 cm in 8 patients, 15 cm in 4 and 10 cm in 3 patients. All were treated with bifocal bone transport (trifocal distraction compression). Total duration of treatment in transport and consolidation was around 15 months in 8 patients, 17 months in 4 patients and 1 year in 3 patients. Additional bone graft was placed in four patients. Pin track infection was universal problem in all patients. There was no major complication. Union was achieved in all cases. Functional and radiological outcome was assessed on ASAMI scoring and showed excellent result in 12 and good in 3 patients.
Conclusion: Bifocal bone transport (trifocal distraction compression) was excellent procedure and decreased the time of bone transport. The placement of the fixator was less as compared with the unifocal bone transport in large defects. However, close monitoring is required and may need additional bone graft at distraction and compression site.
Key words: Bifocal, trifocal distrction compression, bone transport, bone loss, Illizarov, tibia
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