Treatment Of Tibial Non-Union With Bone Defects By Ilizarov Circular External Fixator

Objective:To discuss the appilication value of Ilizarov technique in the treatment of tibial non-union with bone defects.Methods:From July 2007 to June 2010,20cases of tibial non-union with bone defects were treated by Ilizarov circular external fixator with compression fixation (with or without fibular osteotomy) or debridement+Ilizarov bone segmental extension metastasis combining with skin graft debridement or skin flap transplantation surgery at the first stage. Their average age was 32.9years (3 to 56), infected non-union 16 cases, non-infected non-union 4 cases, according to Paley classification:all cases were type B1. The average bone defect was 2cm (1.5 to 5), duration of non-union was 0.25 years to 18 years (mean 1.6 years).Results:20 patients were followed-up an average of 11.6 months (6 to 24).8 patients by postoperative pin tract infection healed after dressing changes,6 patients were affected limb tension vesicle formation healed after symptomatic treatment, common peroneal nerve paralysis were happened in 2 patients gradually restored via symptomatic treatment and active physical exercise. After periodic X-ray inspection line assessment of non-union healing, the skin and soft tissue infection were reoccured in 4 cases and healed after skin graft debridement,9 cases were cured at the first stage and 11 cases cured by secondry operation, the average healing time was 10.8 months (4 to 21).Conclusion:Comparing with traditional surgical treatment the Ilizarov technique in treatment of tibial non-union with bone defects is satisfactory, especially for infected non-union has unique advantages, is a valuable option. But for gain excellent surgical result this method need to be combined with individual tereatment and comprehensive consideration.