Reconstruction of bone loss of diaphyseal tibial bone using circular external fixator

ABSTRACT

Aim was to achieve filling of large diaphyseal defect and simultaneous weight bearing of injured extremity till union was achieved. A metaphyseal corticotomy and gradual distraction of bone segment was performed. We used ilzarove frame on all the cases. Good alignment and stable fixation of bone fragments were achieved. A bone fragment of adequate length [4-10 cm] was created after corticotomy, which was done in proximal or distal tibial metaphyseal area. 7-10 days after corticotomy, fragments were traveled axially across the defect. The transportation was achieved by the use of olive wires and central transporting ring. Regeneration of distraction gap was achieved in all 16 patients. Union at the docking site was achieved in 15 patients and union was not related to length of bone defect. In one patient there was failure of the union at docking site. This was due to incomplete removal of ebernated and atrophic bone ends which was addressed by excision of bone ends and bone grafting. Healing of infection occurred in all patients without second operation. Residual varus deformity remained in two patients with 10 degree and 12 degree respectively. The Ilizarove technique for treatment of segment defects of diaphyseal long bones are effective and offer many advantages. One of the greater advantages of technique is that it allows simultaneous treatment of bone loss, infection, nonunion, deformity and allows weight bearing