Clinical Curative Effect Observation On Treatment Of Tibial Non-Union With Bone Defects By Ilizarov Technique

Background and purpose:Bone is a kind of multifunctional organ, but also is a kind ofbiological material can fully recover and do not leave scar, butthe effects of various physical and biological factors that leadto fracture healing fracture, but still, at this time must be aftersurgical operation intervention can make the fracture connectedwith. In all the fractures, tibia because the special anatomicalstructure, once the fracture, especially with infection of openfracture, there is a great probability of nonunion. The subject ofthe application of Ilizarov external fixation and debridement+tibia bone transfer, or Ilizarov external fixate+debridement plustibia astronomy and with soft tissue defect of cases with one stagedebridement cases of skin or local skin flap transposition in27cases of tibial bone defects not even the summary, to explore thecurative effect of the treatment of nonunion of tibia defect.Methods:2010June to2013March apply Ilizarov external fixation anddebridement+tibia bone transfer, or Ilizarov external fixate+debridement plus tibia astronomy and with soft tissue defect ofcases with one stage debridement treatment of skin grafting or localskin flap transposition in27cases of tibia bone defects not eventhe patients, the average age of33.5(19～57) years,18males,9 females,16cases on the left side, right side in11cases, infection,nonunion in20cases, non infected nonunion of bone defect in7cases,with an average of4.8（3.5～8）cm, the time from injury tohospitalization time averaged1.2(0.1～7) years; previouslytreated1～3times operation. Perfect preoperative examination,Ilizarov external fixation and debridement+tibia bone transfer,or Ilizarov external fixate+debridement+tibia astronomy, ifaccompanied by soft tissue defect after debridement, then take theskin grafting or local skin flap transposition. Beginning10daysafter operation, in0.6～1mm/d speed gradually conveying astronomy,until with the distal realignment, or extend the body to achievethe same with the healthy limb length. Every day4～6times,interval of4～6h. Stop delivery or stop extending from3to May,X-ray, according to the degree of mineralization of bone decidedto remove frame time.Results:27patients with a mean follow-up of14.8months (5.5～24).6cases of patients with postoperative pin tract infection, infectioncontrol by dressing and oral antibiotic treatment, occur tibialaxial offset of3patients in27cases after correction, by adju-sting the diagonal screw relative speed.5cases of patients withwire pull the skin pain, suspended bone transport or bone extendedfor2to3days, the pain disappeared to bone transport or bone leng-thening. No cases of vascular nerve injury.8cases of transpositionflap survived. Regular postoperative X-ray inspection line assess-ment of bone nonunion healing, healing in22cases, two healed in5cases, the average healing time was7.8(4～3) month. In27 patients with bone defect were ultimately obtained bone healing,all patients were good new bone mineralization.Conclusion:Ilizarov external fixation can make the doctor in the wholeperiod of extension speed adjustment, control of fracture, and hasadvantages of simple operation, small trauma, treatment of tibialbone defect nonunion satisfactory.