Clinical Research Of Ilizarov Method On Treatment Of Tibial Bone Defect And Infected Nonunion

Background:Tibial infected bone defect and nonunion are common disorders in the orthopedic trauma. Often accompany with tissue defects, bone exposure, tibial segment itself poor blood circulation, it is very difficult to treat. The traditional methods of treatment is difficult to cure the infection while repairing bone and soft tissue defects, recovering the length of injured limb length, correcting nearby joint deformity, often leads to complications such as foot drop,the Achills tendon contracture, anchylosis, the Limb shortening.Objective:To explore and evaluate the clinical efficacy of Ilizarov technique on treatment of Tibial infected bone defect and non-union, and analyze the advantages and disadvantages of the technique and the best indications.Method:Retrospectively analysing 15 cases of tibial bone defect and infected nonunion, from July 2012 to December 2014, in kunming general hospital,among them,10 cases were male,5 cases were female.Age ranges from 20 to 55 years old, average 36.5 years old.10 cases were traffic injuries, high falling injury 2 cases, heavy pressure parts 3 patients.6 cases were tibia infected bone nonunion, tibia infected bone defect 9 cases, the length of bone defect ranges from 2-15cm,an average of 8.5cm.All cases with soft tissue defect.9 cases were treated by debridement, Ilizarov external fixation, immediately osteotomy, bone transport; while other 6 cases were treated by (stage Ⅰ) debridement, Ilizarov external fixation, (stage Ⅱ) osteotomy, bone transport.12 cases wounds were opened and dressing, other three cases were repaired with flap, including 1 case of the medial gastrocnemius muscle flap,1 case of implicit neurovascular flap,1 case of sural neurovascular flap.Results:All patients were followed from 12 to 24 months, an average of 18 months, all bone and soft defects healed, no case of infection recurrence, limb function was good. Postoperative X-ray radiography examination was taken Regularly to evaluate bone healing process, healing time 4-20 months, the average 10 months, the Limb length recovered well, no obvious difference compared with the healthy side. Major Complications:needle infection in 5 cases, malposition in 9 cases, skin dragging pain in 5 cases,8 cases of varying degrees of ankle dysfunction.Conclusion:With curative effect, taking debridement, Ilizarov external fixation, bone transport technique to treat the tibial non-union and bone defect is an effective way, especially suitable for cases with large bone defect associated with soft tissue defects, limb shortening, the Achilles tendon contracture, foot drop deformity.