Abstract：Objective To investigate the clinical effect of Ilizarov bone transport technique with assisted guiding pin in medullary cavity for treatment of posttraumatic bone defect of tibia. Methods A retrospective case series study was conducted to analyze the clinical data of 17 patients with post-traumatic bone defect of tibia admitted to Third Hospital of Hebei Medical University form November 2014 to March 2018.There were 13 males and 4 females, aged 19-60 years ［(37.2±13.4)years］.The bone defect length was 4.6-14.0 cm ［(8.6±2.8)cm］ after debridement. All patients underwent treatment with Ilizarov bone transport technique. The alignment of transport bone segment was controlled by a guiding pin in medullary cavity of tibia. Bone grafts were performed to accelerate fracture healing of docking point. The wound healing, bone healing, external fixation time, external fixation index (EFI), alignment recovery were recorded. Bone healing and functional results were evaluated according to the criteria given by Association for the Study and Application of the Method of Ilizarov (ASAMI). The complication was recorded according to Paleys criteria. The physical component summary score (PCS) and mental component summary score (MCS) ware recorded according to the MOS 36-item Short-form Health Survey (SF-36) questionnaire and compared with the national norm to evaluate the quality of life. Results After removal of the apparatus, follow-up period was 12-37 months ［(29.9±4.4)months］. Wound healing was achieved without flap transfer. At the latest follow-up, all patients achieved bone healing without recurrent infection. External fixation time was 242-801 days ［(436.5±154.6)days］ and external fixation index was 35.7-60.5 d/cm ［(50.6±6.2)d/cm］. The affected extremity alignment was restored in all patients except for residual angular deformity in one patient. According to ASAMI, the excellent and good rate of bony results and functional results were 88% and 94%. According to Paleys criteria, complications included 12 problems,7 obstacles and 1 sequelae. The PCS and MCS in SF-36 questionnaire were (85.8±11.6)points and (69.6±11.1)points. Compared with the national norm ［PCS: (87.6±16.8)points, MCS: (78.8±15.4)points］, PCS showed no statistical difference (P＞0.05), but MCS showed statistical difference (P＜0.05). Conclusions Ilizarov bone transport combined with intramedullary guiding pin can accelerate wound and fracture healing, control infection and restore lower limb alignment. The physical function of the affected extremity can be restored in spite of some complications and psychological effects. The technique is an effective treatment for posttraumatic bone defect of tibia.
刘彬 王超 王新光 罗俊浩 陈伟 焦振清. Ilizarov骨搬移联合髓内引导针技术治疗胫骨创伤性骨缺损的疗效[J]. 中华创伤杂志, 2020, 36(4): 321-326.
Liu Bin, Wang Chao, Wang Xinguang, Luo Junhao, Chen Wei, Jiao Zhenqing.. Clinical efficacy of Ilizarov bone transport technique combined with intramedullary guiding pin for treatment of posttraumatic tibia bone defect. CHINESE JOURNAL OF TRAUMA, 2020, 36(4): 321-326.
