Management of tibial bone defects by segmental bone transport using Ilizarov technique

Abstract

Background: A tibial defect greater than 4 cm is a common clinical entity, particularly among populations with sever acute trauma, infection sequalae, congenital pseudoarthrosis tibia, and following tumor resection. Segmental bone transport by using an Ilizarov external fixator has become the treatment of choice. The aim of this prospective study was to evaluate the results of using the Ilizarov fixator in the treatment of tibial defects, its advantages, and its complications.
Methods: Our prospective study was conducted involving 44 cases with tibial defects (from 4 to 15 cm) of different causes. All patients are treated by segmental bone transport using an Ilizarov external fixator. All patients were operated on at Zagazig University Hospitals.
Results: 44 patients were followed up from March 2018 to December 2021. Infection was eradicated in all cases, and union was achieved in all cases, with no cases of limb amputation. The infection was eradicated in all the infected cases without the need for prolonged antibiotics and without reactivation throughout the period of follow-up. The union was achieved in all cases.
Conclusions: Distraction histogenesis is a good solution for segmental tibial defects. The Ilizarov technique is complicated and requires a great deal of expertise to perform successfully. Ilizarov’s bone defect reconstruction was less expensive and easier to perform. Bone graft at the docking site may be needed to enhance the union and shorten the time in fixation.