Systematic Review And Meta-analysis Of The Clinical Effect And Complications Of Ilizarov Techniques For The Treatment Of Infected Nonunion With Bone Defect Of Tibia

Objective:The aim of this systematic analysis was to review current available literatures and researches which have been reported on Ilizarov techniques for the treatment of infected nonunion with bone defect of tibia,and to conduct meta-analysis of bone results,functional results and complications to assess the efficacy of Ilizarov techniques,and to better guide our clinical work.Methods:A comprehensive and integrated literature search was conducted from the SCI,PubMed,Cochrane Library and CNKI database between January 1995 and December2015.Some principal data were statistically analyzed using weighted means based on the size of sample content in each study by SPSS 20.0 statistical software,the main date including the number of patients,patient's age,the number of previous surgery,length of bone defects,postoperative follow-up time,bone healing time,postoperative complications of each patients,external fixation time,and external fixation index(EFI).Bone results(excellent,good,fair and poor rate),functional results(excellent,good,fair and poor rate)and postoperative complications were analyzed by Stata 12.0 statistical software.Results:The cumulative total of the number of cases was at 368 from 17 studies which were included in this systematic review.The average rate of bone union was96.527%(87%-100%)in all included literatures.The poor rate of bone results was 9%(95%CI,0.04–0.14;I2=10.9%,P=0.346),the poor rate of functional results was 8%(95%CI,0.03–0.12;I2=12.7%,P=0.332)in patients with infected nonunion of tibia treated by Ilizarov techniques.The rate of kneestiffness,malunion,refracture,infectious recurrence,lower extremity swelling,amputation,peroneal nerve palsy and complications of bone grafting was respectively 13%,7%,4%,5%,12%,3%,11%and 15%.Conclusion:The results of this systematic review showed that the patients with infected nonunion with bone defect of tibia treated by Ilizarov techniques had a high rate of bone union,then the poor rate in bone and functional results were not high,the rate of kneestiffness,malunion,refracture,infectious recurrence,lower extremity swelling,amputation,peroneal nerve palsy and complications of bone grafting was respectively not high.Therefore,Ilizarov techniques may be a good choice for the treatment of infected nonunion with bone defect of tibia because of its satisfactory curative effect and its lower complication rates.