{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:40:01Z","timestamp":1756276801357,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,10,28]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>A man in his 30s was involved in a road traffic accident (RTA) and sustained a grade-IIIA distal femur fracture with acute loss of distal two-third of the femur. Initially, damage control surgery was done by an external fixator application. Later, staged limb reconstruction surgery was undertaken as a definitive procedure that involved bifocal distraction osteogenesis involving the proximal tibia and femur along with docking of the corticotomised femoral fragment onto the tibial plateau to achieve knee arthrodesis. The tibial and femoral regenerate together measured 25.8 cm at the end of distraction phase leaving behind a limb length discrepancy of 5 cm. Acute traumatic large bone loss is a rare presentation and is beset with unique management challenges. Limb reconstruction surgery (LRS) with LRS system provides flexibility to tackle individual case-based scenarios and helps achieve limb length, maintain alignment and restore function.<\/jats:p>","DOI":"10.1136\/bcr-2023-254863","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T12:06:42Z","timestamp":1699963602000},"page":"e254863","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Tibial lengthening for massive distal femoral bone loss"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1031-9245","authenticated-orcid":false,"given":"Tushar Narayan","family":"Rathod","sequence":"first","affiliation":[{"name":"Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4594-5780","authenticated-orcid":false,"given":"Shivaprasad Sharangouda","family":"Kolur","sequence":"additional","affiliation":[{"name":"Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhishek Kumar","family":"Rai","sequence":"additional","affiliation":[{"name":"Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhruv","family":"Paul","sequence":"additional","affiliation":[{"name":"Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,11,14]]},"reference":[{"key":"2025082623232489000_16.11.e254863.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2009.07.011"},{"key":"2025082623232489000_16.11.e254863.2","doi-asserted-by":"crossref","DOI":"10.1186\/s10195-019-0522-6","article-title":"Induced membrane technique using enriched bone grafts for treatment of Posttraumatic segmental long bone defects","volume":"20","author":"Piacentini","year":"2019","journal-title":"J Orthop Traumatol"},{"key":"2025082623232489000_16.11.e254863.3","doi-asserted-by":"crossref","DOI":"10.1097\/OI9.0000000000000059","article-title":"Managing bone loss in open fractures","volume":"3","author":"Adamczyk","year":"2020","journal-title":"OTA International"},{"key":"2025082623232489000_16.11.e254863.4","first-page":"304","article-title":"Role of the Ilizarov non-free bone Plasty in the management of long bone defects and Nonunion: problems solved and unsolved conflict-of-interest statement: PRISMA 2009 checklist statement","volume":"11","author":"Borzunov","year":"2020","journal-title":"World J Orthop Submit a Manuscr World J Orthop"},{"key":"2025082623232489000_16.11.e254863.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2011.11.001"},{"key":"2025082623232489000_16.11.e254863.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2010.02.010"},{"key":"2025082623232489000_16.11.e254863.7","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5413.159638"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-254863","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:23:36Z","timestamp":1756275816000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-254863"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":7,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,14]]},"published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1136\/bcr-2023-254863"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-254863","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}