| Objective The target of this study is to explore the clinical effectiveness of treatment of tibia chronic osteomyelitis and tibial bone defect by Ilizarov method, and to provide with better clinical technology and basis.Method From december 2011 to june 2013, 28 case of tibia chronic osteomyelitis and tibial bone defect which are all from the orthopadiecal department of first affiliated hospita of Zhengzhou University are retrospectively analysed. And all the patients are treated by the Ilizarov method. There are 20 males and 8 females,aging from 22-49(31.4 on average).25 cases belong to unactive infection,the number of active infection are 3.All the patients received the sugery treatment, the average number of previous operation are 2.3. The injured part of 10 cases is on the left tibia,the number of right is 18. 12 cases involve the upper tibia, 9 cases are middle tibia, and the rest is on the inferior tibia.. To the first operation, 13 patients are treated by external fixator, 8 patients choosed the locked plate, the rest 7 involved the tibia intramedully nailing.The time from the injury to our operation ranged from 9 to 25 month( 13.7 month on average).After having related medical examinations, all of 28 patients received the treatment of Illizarov methond. At the beginning of the operation, we make the osteotomy on the metaphysis of tibia and remove the infected tissue and dead bone. If the wound has good tissue, we choose the sutura to close it; if the wound are large tissue defect,then VSD treatment seems to be reliable, and then choose to skin-graft or flap treatment. In the follow-up time, we like to use the Hss and Baird-Jackson score standard to assess the function of knee and ankle to assess the bone function.All the data of 28 cases in the matter of age,sex and the length of bone defect,have no significant statistical difference.Results Having a follow-up plan from 8-16 month(mean 10.8 months), all of the patients have no other injuries and deaths during the follow-up period. All patients with bone defect length on average 8.7 cm(4.4-11.6 cm), bone removal 60-150 days(90 days), and take time for 10 ~ 40 months, an average of 15.6 months, bone healing index for 3 d l/cm. Knee Hhs score: ankle Baird- Jackson score:;But in 2 cases, fine rate was 92.6%. All steel pull 5 patients in patients with skin pain, 3 patients had the needle infection, 2 cases of patients with postoperative tibial axial offset, and approved by relevant measures to control. 15 cases of skin grafting and 2 flap transposition were successful.Conclusions Ilizarov method was applied to the chronic osteomyelits and bone defect of tibia, with good clinical effectiveness, little trauma, quick recovery, short course of disease, the characteristics of low cost. Ilizarov technology both can effectively control infection, properly fix limb, handling extension of bone tissue, also can adjust move during bone block to prevent deviation and deformity. |
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