Abstract & Overview
Context: Ilizarov method of bone transport is a well-recognized method in treating bone loss; however, soft tissue complications and potential flap compromise associated with the transport process are a major drawback. Aim: We propose the use of a central transport system of cables and pulleys, as introduced by Weber in 1998 to help preserve soft tissue cover, retain flap integrity, and decrease patient discomfort. Design: This was a retrospective study. Patients and Methods: Consecutive series of patients treated for severe bone loss and fragile soft tissue cover, between 2013 and 2018, according to the Weber method of bone transport, were included in the study. In total, six cases were identified. Inclusion criteria were any patient who underwent bone transport using the Weber method due to bone loss caused by trauma or infection. Exclusion criteria were any patient who did not complete the bone distraction process or had a follow-up of <1 month after bone transport apparatus installation. Results: Five out of six patients completed the bone transport process; one case was excluded from the results since the patient was lost to follow-up before bone distraction was begun. The average follow-up was 13.2 months; no patient had soft tissue complications, the transport process was painless, and the flap integrity was maintained. Bone regenerate was good in all except one case since the patient was lost to follow-up a month after transport was initiated. Conclusion: The Weber method is a reliable technique generating good-quality bone, while maintaining the integrity of the soft tissue envelope, minimizing soft tissue complications associated with the classical method of bone transport. The Weber technique is especially valuable when bone transport is performed in a flap covered area, where the excursion of half pins and K-wires can compromise flap survival.