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Year : 2021  |  Volume : 7  |  Issue : 2  |  Page : 88-97

Acquired long bone defect classifications of the diaphysis: A literature review

1 Department of Military Traumatology and Orthopedics, S.M. Kirov Military Medical Academy, 13 Botkinskaya str., Moscow, Russian Federation
2 Department of Orthopaedic Trauma, Moscow City Clinical Hospital #13, 1/1 Velozavodskaya str., Moscow, Russian Federation
3 Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery, New York, USA
4 Department of Traumatology and Orthopedics, Vreden National Medical Research Center of Traumatology and Orthopedics, 8 Akademik Baykov str.; Chair of Traumatology and Orthopedics, Saint Petersburg State Pediatric Medical University, 2 Litovskaya str., Moscow, Russian Federation

Correspondence Address:
Dr. Gerard A Sheridan
Hospital for Special Surgery, New York, NY
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jllr.jllr_27_21

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Introduction: The management of acquired long bone defects (LBDs) is a persistent problem in modern orthopedics with few effective solutions. The goal of this review is to conduct a thorough analysis of existing diaphyseal LBD classifications and to identify if any of these may be adopted for universal application in future. Materials and Methods: A literature review was performed analyzing articles between 1970 and 2019 on PubMed (English) and CyberLeninka (Russian) databases. All studies developing or utilizing a classification tool were eligible for inclusion. The search retrieved a total of 1032 articles from PubMed, 477 from CyberLennika, and 28 articles from reference lists. Any disagreement regarding the inclusion of articles was resolved by consensus between all authors. Results: A total of 18 classifications in the literature underwent analysis. Among the classifications we analyzed, 12 described posttraumatic defects, 6 described osteomyelitis defects or infected nonunions, and 5 described, among other defects, iatrogenic bone. Of the 18 classifications, 12 have a focus on a specific treatment method. We found that consensus exists between most authors regarding the criteria necessary to measure to determine the most appropriate treatment method. These key factors include the size and location of the bone defect. Conclusion: This analysis showed that despite the large number of publications devoted to the classification and treatment of LBD, there is still no consensus among authors regarding not only a universal clinical classification but also a general definition of the term “bone defect.” The classification proposed by Solomin et al. is very useful but in its present form, has significant drawbacks and requires further improvement before it can be adopted as a universal classification system for LBDs.

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