Automated Balanced Cable Trifocal Bone Transport

Case: A 14-year-old adolescent boy sustained a Gustilo-Anderson Type 3A tibia fracture treated with medullary nailing. He developed an atrophic nonunion with a 10.5-cm defect after debridement. An automated hexapod system was adapted to perform trifocal tandem cable transport. Transport proceeded at 0.75 mm/day per focus, segmented into 16 increments. Docking and conversion to a nail occurred 103 days after frame application for an external fixation index of 9.8 days/cm. Conclusion: Automated balanced cable transport is a viable option for segmental bone defects. This is the first reported automated balanced cable transport.