REPAIR OF LARGE TIBIAL BONE AND SOFT TISSUE DEFECTS BY SHORTENING-LENGTHENING METHOD_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YIN Qudong , SUN Zhenzhong , GU Sanjun , WEI Xuming , SONG Sheng , MA Yunhong.

Department of Orthopaedics, Wuxi No.9 People’s Hospital, Wuxi Jiangsu, 214062, P.R.China. Corresponding author: SUN Zhenzhong, E-mail: wxsyqd@163.com;

Corresponding author：

Keywords：

Tibial bone defect; Soft tissue defect; Shortening-lengthening method; Ilizarov technique

DOI：

10.7507/1002-1892.20130321

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Objective To investigate the effectiveness of shortening-lengthening method using Ilizarov technique for repairing large tibial bone and soft tissue defects. Methods Between January 2006 and December 2011, 12 patients with large tibial bone and soft tissue defects were treated by shortening-lengthening method using Ilizarov technique. There were 8 males and 4 females with an average age of 39.3 years (range, 18-65 years). The causes were injury in 8 cases and chronic infection in 4 cases. The area of soft tissue defect was 5 cm × 4 cm to 20 cm × 16 cm, and the length of tibial bone defect was 4.5-8.0 cm with an average of 6.2 cm. Results Incision in the lengthening area healed by first intention; healing of wounds by first intention was achieved in 6 cases, delayed healing in 2 cases, and secondary healing in 4 cases, with no common peroneal nerve injury. All patients were followed up 18-54 months with an average of 29 months. In the lengthening area, the bone healing time was 180-365 days (mean, 267 days), and the healing index was 3.8-4.3 days/mm (mean, 4.1 days/mm). In the shortening area, the bone healing time was 195-380 days (mean, 297 days) in the others except 1 case who was repaired with bone grafting. Mild pin-related infection and loosening were observed in all cases, but no infection occurred in the lengthening or shortening area. At last follow-up, weight bearing of the leg was fully recovered in 12 cases. According to Mazur’s criteria, the function of ankle was excellent in 2 cases, good in 6 cases, and fair in 4 cases. Nine patients had equal limb length, and 3 patients had shortened length less than 2 cm. Conclusion Shortening-lengthening method using Ilizarov technique has the advantages of simple surgery, less complications, easy to close the wound, and good effectiveness in repairing of large tibial bone and soft tissue defects．

Citation： YIN Qudong,SUN Zhenzhong,GU Sanjun,WEI Xuming,SONG Sheng,MA Yunhong.. REPAIR OF LARGE TIBIAL BONE AND SOFT TISSUE DEFECTS BY SHORTENING-LENGTHENING METHOD. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(12): 1462-1465. doi: 10.7507/1002-1892.20130321 Copy

1.	刘会仁, 王立新, 张艳茂, 等. 组织移植结合骨滑移治疗小腿皮肤软组织伴大段胫骨缺损. 中国修复重建外科杂志, 2013, 27(3): 295-298.
2.	武进华, 冯志斌, 张建河, 等. 骨段滑移术治疗胫骨缺损合并软组织缺损. 实用骨科杂志, 2012, 18(2): 132-136.
3.	Krappinger D, Irenberger A, Zegg M, et al. Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment. Arch Orthop Trauma Surg, 2013, 133(6): 789-795.
4.	McKee MD, Yoo DJ, Zdero R, et al. Combined single-stage osseous and soft tissue reconstruction of the tibia with the Ilizarov method and tissue transfer. J Orthop Trauma, 2008, 22(3): 183-189.
5.	李刚, 秦泗河. 牵拉成骨技术的基础研究进展与带给骨科的启示. 中华外科杂志, 2005, 43(8): 540-543．.
6.	秦泗河. Ilizarov技术概述. 中华骨科杂志, 2006, 26(9): 642-645.
7.	房国军, 吴其常. Ilizarov技术的临床应用. 中国矫形外科杂志, 2005, 13(20): 1579-1581.
8.	黄雷, 赵刚, 王慎东, 等. 短缩-延长肢体治疗胫骨骨缺损合并软组织缺损. 中华创伤骨科杂志, 2007, 9(12): 1115-1119.
9.	陈志强, 韩立仁, 翁海滨, 等. Ilizarov技术治疗急性胫骨骨缺损合并软组织缺损. 中国医师进修杂志, 2010, 33(23): 27-29.
10.	韩立仁, 穆卫东, 陈志强, 等. Ilizarov骨搬移技术治疗胫骨大段骨缺损合并软组织缺损. 中华创伤杂志, 2011, 27(10): 901-904.
11.	郑战营, 薛云峰. 急性骨短缩-延长加骨髓移植治疗胫骨骨折并骨缺损. 中国骨伤, 2005, 18(11): 689-690.
12.	胡金龙, 王静成, 颜连启. 组织工程学技术治疗骨缺损的最新研究进展. 中国矫形外科杂志, 2013, 21(2): 150-153.
13.	秦泗河. 突破骨不连与骨缺损治愈的瓶颈. 中国骨伤, 2013, 26(4): 267-270.
14.	Robert Rozbruch S, Weitzman AM, Tracey Watson J, et al. Simultaneous treament of tibial bone and soft-tissue defects with the Ilizarov method. J Orthop Trauma, 2006, 20(3): 197-205.
15.	吴伟. Ilizarov技术在急性胫骨缺损合并软组织缺损治疗中的应用. 山东医药, 2011, 51(14): 72-73.
16.	栾波, 陈艺新, 张云强, 等. 加压延长技术治疗病理性肢体大段骨缺损的研究及应用. 贵州医药, 2008, 32(7): 587-589.
17.	安智全, 赵金忠, 曾炳芳. 加压延长与骨迁移修复胫骨长段骨缺损. 中国修复重建外科杂志, 2006, 20(8): 864-866.
18.	王兴国, 王伟, 王兴义, 等. 应用Ilizarov技术一期治疗合并皮肤缺损的胫骨感染性骨缺损. 中国骨伤, 2010, 23(6): 422-425.
19.	Charalambous CP, Akimau P, Wilkes RA. Hybrid monolateral-ring fixator for bone transport in post-traumatic femoral segmental defect: a technical note. Arch Orthop Trauma Surg, 2009, 129(2): 225-226.
20.	龙超, 刘炳胜, 王玮, 等. 环形外固定架骨搬运治疗胫骨创伤后大段骨缺损. 中国骨伤, 2013, 26(4): 281-283.

1. 刘会仁, 王立新, 张艳茂, 等. 组织移植结合骨滑移治疗小腿皮肤软组织伴大段胫骨缺损. 中国修复重建外科杂志, 2013, 27(3): 295-298.
2. 武进华, 冯志斌, 张建河, 等. 骨段滑移术治疗胫骨缺损合并软组织缺损. 实用骨科杂志, 2012, 18(2): 132-136.
3. Krappinger D, Irenberger A, Zegg M, et al. Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment. Arch Orthop Trauma Surg, 2013, 133(6): 789-795.
4. McKee MD, Yoo DJ, Zdero R, et al. Combined single-stage osseous and soft tissue reconstruction of the tibia with the Ilizarov method and tissue transfer. J Orthop Trauma, 2008, 22(3): 183-189.
5. 李刚, 秦泗河. 牵拉成骨技术的基础研究进展与带给骨科的启示. 中华外科杂志, 2005, 43(8): 540-543．.
6. 秦泗河. Ilizarov技术概述. 中华骨科杂志, 2006, 26(9): 642-645.
7. 房国军, 吴其常. Ilizarov技术的临床应用. 中国矫形外科杂志, 2005, 13(20): 1579-1581.
8. 黄雷, 赵刚, 王慎东, 等. 短缩-延长肢体治疗胫骨骨缺损合并软组织缺损. 中华创伤骨科杂志, 2007, 9(12): 1115-1119.
9. 陈志强, 韩立仁, 翁海滨, 等. Ilizarov技术治疗急性胫骨骨缺损合并软组织缺损. 中国医师进修杂志, 2010, 33(23): 27-29.
10. 韩立仁, 穆卫东, 陈志强, 等. Ilizarov骨搬移技术治疗胫骨大段骨缺损合并软组织缺损. 中华创伤杂志, 2011, 27(10): 901-904.
11. 郑战营, 薛云峰. 急性骨短缩-延长加骨髓移植治疗胫骨骨折并骨缺损. 中国骨伤, 2005, 18(11): 689-690.
12. 胡金龙, 王静成, 颜连启. 组织工程学技术治疗骨缺损的最新研究进展. 中国矫形外科杂志, 2013, 21(2): 150-153.
13. 秦泗河. 突破骨不连与骨缺损治愈的瓶颈. 中国骨伤, 2013, 26(4): 267-270.
14. Robert Rozbruch S, Weitzman AM, Tracey Watson J, et al. Simultaneous treament of tibial bone and soft-tissue defects with the Ilizarov method. J Orthop Trauma, 2006, 20(3): 197-205.
15. 吴伟. Ilizarov技术在急性胫骨缺损合并软组织缺损治疗中的应用. 山东医药, 2011, 51(14): 72-73.
16. 栾波, 陈艺新, 张云强, 等. 加压延长技术治疗病理性肢体大段骨缺损的研究及应用. 贵州医药, 2008, 32(7): 587-589.
17. 安智全, 赵金忠, 曾炳芳. 加压延长与骨迁移修复胫骨长段骨缺损. 中国修复重建外科杂志, 2006, 20(8): 864-866.
18. 王兴国, 王伟, 王兴义, 等. 应用Ilizarov技术一期治疗合并皮肤缺损的胫骨感染性骨缺损. 中国骨伤, 2010, 23(6): 422-425.
19. Charalambous CP, Akimau P, Wilkes RA. Hybrid monolateral-ring fixator for bone transport in post-traumatic femoral segmental defect: a technical note. Arch Orthop Trauma Surg, 2009, 129(2): 225-226.
20. 龙超, 刘炳胜, 王玮, 等. 环形外固定架骨搬运治疗胫骨创伤后大段骨缺损. 中国骨伤, 2013, 26(4): 281-283.

Chinese Journal of Reparative and Reconstructive Surgery

REPAIR OF LARGE TIBIAL BONE AND SOFT TISSUE DEFECTS BY SHORTENING-LENGTHENING METHOD

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