Analysis Of The Clinical Effects Of "Accordion Technique" In The Treatment Of Tibial Bone Defects With Ilizarov Technique

Objective:To discuss clinical outcomes of accordion operation for the Ilizarov technique in treating tibial bone defects.Methods:From June 2010 to September 2014,we treated 22 patients with tibial bone defects using Ilizarov bone-transport technique.males: 19 cases,females: 3 cases;Ages23-60 years old,average 44.04 years old;the length of the bone defects before the bone transport: 5-11 cm,the average length of the bone defects: 7.68 cm;Cause of injury: 14 cases of traffic accidents,3 cases of fall injury,4 cases of smashing injury,1 cases of high drop injury;6 cases on the left and 16 cases on the right.Divided into two groups,Accordion group: Eleven cases,"accordion operation" were performed after bone transport was completed;Control group: Eleven cases,the external fixator is locked waiting for bone consolidation after bone transport was completed.All patients were followed up for 18-36 months,the average time is 27.9 months.There was no statistical significance in both groups,such as sex,age,length of bone defect.(P > 0.05).Analysis of healing time,healing index and other indicators,and Paley's criterion was used to evaluate the healing effect of bone healing and function recovery of the limb.Results:The result of X-ray evaluation was that all patients achieved bone healing.Accordion group: the bone healing time(365 ± 91)days,the bone healing index(46.2 ±3.5)d / cm;Control group: the bone healing time(435 ± 108)days,the bone healing index(57.8 ± 3.5)d / cm.There was no statistical significance in the bone healing time between the two groups(t=1.648: P=0.115);There was statistical significance in the bone healing index between the two groups(t=7.754,P=0.000).The final follow-up according to Paley's criterion: accordion group: excellent in 9 cases,good in 2 cases,excellent and good rate of 100%;control group: excellent in 8 cases,good in 3 cases,excellent and good rate of 100%;Score was not statistically significant(z=-0.479,P=0.619).Complications: nail infection: accordion group:9 cases,control group: 10 cases;local traction pain: accordion group: 2 cases,control group: 1 case;axial malalignment >10°: accordion Group 4 cases,control group 3 cases;location difference of the junction of bone defects: accordion Group 3 cases,control Group 2 cases;Complications were not statistically significant(P>0.05).Conclusion:1."Accordion technology" for bone transport in the treatment of tibia defects can shorten the bone healing time;2."Accordion technology" for bone transport in the treatment of tibia defects can improve mineralization ability;3."Accordion technology" for bone transport in the treatment of tibia defects can improve the healing index;4."Accordion technique" for bone transport in the treatment of tibial defects can get good results.