114 Bone Transport Using the Monorail External Fixator Over an Intramedullary Nail for Post-Traumatic Femoral Defects

Abstract Aim The management of limb-length discrepancy secondary to traumatic bone loss poses a unique challenge for surgeons. Ilizarov technique is popular but associated with long external fixator time and many complications. This retrospective study assessed outcomes post-traumatic femoral defects managed by monorail fixation over an intramedullary nail. Method Eight patients were included from four-year period defects, that underwent treatment fixator-assisted nailing. Mean follow-up was 232.83 weeks. Five open fractures (Gustilo-Anderson type 3A:n=4, 3B:n=1), one had closed fracture. Average defect size 8cm. Primary lengthening index, consolidation index. Secondary full weight bearing(FWB), union, Patient reported outcome measures including EQ-5D-5L, SF-36, Oxford knee scores(OKS), hip scores(OHS) recorded after recovery. Results index 11.35months 1.24months/cm, respectively. 20.2days/cm 23.88days/cm, On average, achieved FWB union 56.25 weeks 68.83 transport initiation, Two docking site non-union, treated reamed exchange osteomyelitis. EQ-5D-5L EQ-VAS scores compared UK population norms (p=0.104, p=0.238, respectively). OKS 32.17 OHS 34.00. Conclusions Monorail nail effective option reducing time, lowering complication rate, returning patients’ quality life level comparable the normal population.