Treatment of infected bone defect of tibia by ilizarov technique

Objective To explore the treatment efficacy of ilizarov technique in infected bone defect of tibia. Methods Three hundred and fifteen patients (236 males and 79 females) with infected bone defect of tibia who underwent ilizarov technique from January 2008 to December 2012 were observed, their average age was 35 years old (range from 14-72 years old) and the average illness duration was 9 months (range from 2 months-10 years). The infected defect occurred on the proximal tibia in 86 patients, shaft tibia in 92 patients and distal tibia in 137 patients. 146 patients were with soft tissue defects. The average lengthening of bone defects was 8 cm (range from 2-18 cm) with duration of follow-up from 1 to 6 years (average of 28 months). The healings of bone and soft tissue, surgical complications were observed postoperatively. Results Infections of all patients were cured and no recurrence was observed. Soft tissue defects were healed. One-stage bone healing was achieved in 63 patients who underwent short lengthening contraction and in 147/252 patients who performed bone transport. Among patients without one-stage bone healing, 97 patients achieved secondary healing by iliac cancellous bone implanting at the bone stumps, 8 patients at the lengthening areas. The foot drop deformity were developed in 8 patients, pin tract infections in 15 patients, 2 patients were fractured again after removing the external fixators, and bone segmental axial deviation in 10 patients. All patients with complications underwent the corresponding treatments and achieved good results. Conclusion Completely debriding, curing bone nonunion, repairing the soft tissue defects and restore the extremity length can be achieved by ilizarov technique for patients with infected bone defect of tibia, and the outcomes of primary operation are satisfactory.