{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T10:54:47Z","timestamp":1782989687927,"version":"3.54.5"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1]]},"abstract":"\n Objectives:<\/jats:title>\n To analyze long-term functional outcomes in patients with posttraumatic infected tibial nonunions having undergone bone transport with hexapod external fixator.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n Level 1 trauma center.<\/jats:p>\n <\/jats:sec>\n \n Patients\/Participants:<\/jats:title>\n Thirty-eight patients with infected nonunions of the tibia.<\/jats:p>\n <\/jats:sec>\n \n Intervention:<\/jats:title>\n Resection of nonunion with application of stacked hexapod external fixator for bone transport.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measurements:<\/jats:title>\n Functional outcome was measured using the short Musculoskeletal Functional Assessment (sMFA). Parameters measured included age, sex, presence of diabetes, smoking, use of a free flap, bone defect size, length in frame, external fixation index, and direction of lengthening.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The mean sMFA score for the entire group was 27.1. Average patient age was 46.8 \u00b1 12.7 years, 74% patients were male, 8% were diabetic, and 29% were smokers. Seventeen patients had soft-tissue defects that required a free flap. Smokers had higher degrees of disability compared with nonsmokers (39 \u00b1 16 vs. 22 \u00b1 14, P<\/jats:italic> = 0.011). Patients requiring adjunctive stabilization had worse functional scores compared with those who did not receive adjunctive stabilization (33 \u00b1 17 vs. 22 \u00b1 15, P<\/jats:italic> = 0.049). Sixteen patients returned 2 sMFA surveys at different time points after completion of bone transport. Initial average sMFA score was 26.5 at a mean of 25.3 months; subsequent sMFA scores averaged 19.4 at a mean of 98.8 months.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Stacked hexapod external fixator bone transport is a reliable technique for infected nonunion of the tibia with bone loss. Improved sMFA scores can be expected from 2 to 8 years, suggesting full recovery takes longer than previously anticipated. Limb salvage with hexapod bone transport is justified over time.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bot.0000000000001005","type":"journal-article","created":{"date-parts":[[2017,8,23]],"date-time":"2017-08-23T01:00:08Z","timestamp":1503450008000},"page":"e12-e18","source":"Crossref","is-referenced-by-count":26,"title":["Hexapod Stacked Transport for Tibial Infected Nonunions With Bone Loss: Long-Term Functional Outcomes"],"prefix":"10.1097","volume":"32","author":[{"given":"Joshua K.","family":"Napora","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Weinberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blake A.","family":"Eagle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram 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