The Preliminary Analysis On Ilizarov Technique Treatment Of Tibial Bone Defect Nonunion Or Delayed Union

Objectives Through preliminary analyzing Ilizarov technique application in the treatment of tibial delayed union or nonunion, probe on relevant various factors on that in the process of treatment. And strengthen the clinician’s know and comprehend on tibial delayed union or nonunion and the Ilizarov technology, which can better guide clinical work and improve the cure rate of Ilizarov technology in clinical application.Methods 65 cases that are clinical and imaging data s of the patients who are the tibial delayed union or nonunion led by different reasons from June 2006 to June 2014 in the Tangshan Second Hospital are retrospectively analyzed by a case-control study. At first, take the diagnostic criteria of fracture delayed union or nonunion as the basis. In accordance with the end of the healing status after using the technique of Ilizarov bone segment frifting, the 65 cases are divided into two groups, the healing group(control group) and nonunion group(observation group). The healing group includes 31 cases, the nonunion group includes 34 cases. Secondly, utilizing chi square test do single factor analysis of statistics for the two groups’ patients including gender, smoking, drinking, wound, wound infection, tissue defect, fibula fractures, nerve damage, venous thrombosis, osteotomy and soft tissue compression index. Adopting T test do single factor analysis of statistics for the age index of the two groups’ patients. Then getting the results of the preliminary causes analysis of Ilizarov technique application in the treatment of tibial delayed union or nonunion. Then doing single factor non conditional Logistic regression analysis for all the positive results, find it’s confounding factors which may occur. Next, doing the multi factor non conditional Logistic regression analyze for the main variables that have statistical correlation with Ilizarov technique application in the treatment of tibial delayed union or nonunion in single factor analysis of statistics. Finally determine the direct factor and OR value that effects the tibial delayed union or nonunion after applying the Ilizarov technique in the treatment. In addition, adopting the end of bone graft in the treatment for nonunion’s patients. At the same time, take the corresponding parts of the tissues to conduct histological analysis, in order to obtain histological basis of the end of healing.Results Through T test for the age index; do single factor analysis of statistics for the other 11 factors to find that gender(P=0.643), tibia fracture(1/3, P=0.716; 1/3, P=0.571;1/3, P=0.796), osteotomy(P=0.174), venous thrombosis(a total of 4 kinds of P=0.786 factors for Ilizarov treatment after the end of the tibia nonunion or delayed union no statistical significance(P > 0.05), then do single factor non conditional Logistic regression analysis model to test the remaining 8 statistically significant factors and get that age, smoking, and bone fracture, soft tissue defect, wound infection, soft tissue entrapment(P < 0.05), a total of 6 factors are the main influence factors of the Ilizarov technique in the treatment of tibial plateau to end delay union or nonunion of. Removing interference of confounding factors, choose multiple factor non conditional Logistic regression model analysis, Hosmer-Lemeshow test show that =19.734, P=0.04, the results fit well. Thus finally determinate the above 6 factors that are the main risk factors(P < 0.05) to lead the Ilizarov technique in the treatment of tibial plateau to end delay union or nonunion. Especially the soft tissue entrapment(OR=6.347, 95%CI:0.680~10.237), wound infection(OR=5.233, 95%CI:1.491~8.732) and soft tissue defects of the tibia(OR=5.308, 95%CI:1.629~7.335) are more influential for tibial plateau to end. c2Conclusions 1 In the process of healing in docking site, inflammatory reaction, appear around the soft tissue injury repair or neoplasm may be the end cover or package, and then suppress or delay the end of healing. 2 The factors and Ilizarov of tibial bone transport after the end of healing is closely related to the factors including age, smoking, and systemic factors, local factors in the fibula fracture, soft tissue entrapment, wound infection, soft tissue defects of four factors. 3 The Ilizarov bone transport as the treatment of tibial defects because of nonunion or delayed healing of choice.4 Iliac bone grafting is a common and effective method of docking site after long time nonunion of tibial bone transport.