Clinical Research For Bone Transport Of Proximal And Distal Treating Chronical Tibial Osteomyelitis

PurposeWhether different directions of tibia bone transport contribute to similar outcomes is an attractive subject.The aim of this study is to compare the outcomes of bone healing and foot and ankle function between proximal and distal tibia bone transport treating chronic tibial osteomyelitis.The optimal ratio of bone transport on tibial is also explored.Patients and method42 patients undergone bone transport surgery for chronic tibial osteomyelitis from July 2012 to July 2017 were retrospectively reviewed.All the patients were divided into proximal tibia bone transport group and distal tibia bone transport group.The outcomes of external fixation index and foot and ankle function measured by the American Orthopaedic Foot and Ankle Society Ankle-Hind foot Scale were compared.ResultsThere is no statistical difference of external fixation index between both directions of tibia bone transport(F=0.031,P =0.861,CI=95%).At the same time,callus distraction direction has a significantly different efficiency on foot and ankle function(F=25.559,P<0.001,CI=95%).At last,distraction osteogenesis no less than 6.9cm has a greater incidence of docking obstruction(x2=5.433,P=0.029,CI=95%).ConclusionTibia bone transport direction has no significant influence on EFI,but proximal tibia callus distraction has a lower obvious negative effect on foot and ankle function.Proximal tibial osteotomy can be given priority when both ends of tibia can be osteotomized.When only distal osteotomy can be selected,the ankle joint can be fixed in neutral position with ring frame.It should be taken into consideration that bone transport more than 18.80%of its original length will unexpectedly face obvious high incidence of docking struction.