• 1. The 1st Department of Hand Surgery, Reconstruction Surgery, the Second Hospital of Tangshan(The Orthopedic Hospital Affiliated to North China University of Science and Technology), Tangshan Hebei, 063000, P. R. China;
  • 2. Department of Ophthalmology, Kailuan General Hospital Affiliated to North China University of Science and Technology;
  • 3. Department of Orthopaedics, Rehabilitation Hospital Affiliated to National Research Center for Rehabilitation Technical Aids;
WANGBin, Email: wbladyp3@163.com
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Objective To explore the effectiveness of bone transportation by ring type extenal fixator combined with locked intramedullary nail for tibial non-infectious defect. Methods Between June 2008 and October 2012, 22 cases of tibial large segment defect were treated. There were 15 males and 7 females, aged 24-58 years (mean, 36.8 years), including 17 cases of postoperative nonunion or malunion healing, and 5 cases of large defect. After debridement, bone defect size was 5.0-12.5 cm (mean, 8.05 cm). Bone transportation was performed by ring type external fixator combined with locked intramedullary nail, the mean indwelling duration of external fixation was 10.2 months (range, 2-26 months); the external fixation index was 1.57 months/cm (range, 0.3-3.2 months/cm); and the mean length increase was 8.05 cm (range, 5.0-12.5 cm). Results All patients were followed up 19-58 months (mean, 32 months). No infection occurred after operation and all patients obtained bony union, and the union time was 4.7-19.4 months (mean, 11.9 months). Complications included refracture (1 case), skin crease (1 case), lengthening failure (1 case), foot drop (2 cases), retractions of the transport segment (1 case), delay of mineralization (1 case), which were cured after corresponding treatment. According to Hohl knee evaluation system to assess knee joint function after removal of external fixator and intramedullary nail, the results were excellent in 15 cases, good in 5 cases, and fair in 2 cases, with an excellent and good rate of 90.9%; according to Baird-Jackson ankle evaluation system to evaluate ankle joint function, the results were excellent in 10 cases, good in 3 cases, fair in 7 cases, and poor in 2 cases, with an excellent and good rate of 59.1%. Conclusion Bone transportation by ring type external fixator combined with locked intramedullary nail could increase stability of extremities, allow early removal of external fixator and avoid axis shift of extremities, so it has good effect in treating tibial noninfectious defect.

Citation: WANGBin, JIASong, LUAidong, QINSihe, LIUWei, HAORuizheng, WANGWei, HUOYongxin, ZHAOGang. BONE TRANSPORTATION BY RING TYPE EXTERNAL FIXATOR COMBINED WITH LOCKED INTRAMEDULLARY NAIL FOR TIBIAL NON-INFECTIOUS DEFECT. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(11): 1348-1352. doi: 10.7507/1002-1892.20150291 Copy

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