use of ilizarov technique in management of tibial non unions with bone loss

ABSTRACT

Sixteen patients aged 22-55 years were treated for tibial non-union [14 atrophic, two hypertrophic] with bone loss [1-10 cm, mean 5.2 cm] by the llizarov technique and fixator. Nine had chronic osteomyelitis, 12 had a bony defect [2-8 cm], mean 2.9 and 10 had a deformity. Non-union, bone defects, limb shortening, and deformity all were addressed simultaneously with the Ilizarov apparatus Bone defects were closed from within without bone grafts by the llizarov bone transport technique of sliding a bone fragment internally, producing distraction osteogenesis behind it until the defect is bridged [internal lengthening]. Length was re-established by distraction of a percutaneous corticotomy. The resulting distraction osteogenesis obviated the need for a bone graft in every case. Deformity was corrected by means of hinges on the apparatus. Infection was treated by radical resection of the necrotic bone and internal lengthening to regenerate the excised bone. Union was achieved in all cases. The mean time to union was 16 months. The bone results were excellent in 10 cases [62.5%] good in 4[25%] and fair in 2[12.5%]. The functional results were excellent in 11[68.75%] cases good in 3[18.75%] fair in 2 [12.5%]