Single-level osteotomy and bone transfer combined with intramedullary nail in the treatment of tibial bone defect

doi:10.12307/2022.506

Abstract

Abstract: BACKGROUND: Bone transfer is an effective treatment of bone defect caused by various causes. However, the complications, such as long wearing time of the external fixator, the loss of extended bone length, and bending deformities, restrict its application.
OBJECTIVE: To explore the difference in the efficacy of single-level osteotomy combined with intramedullary nail and single-level osteotomy in the treatment of tibial bone defect.
METHODS: Patients with tibial bone defect were selected from Tangshan Second Hospital from January 2011 to April 2018. Fifteen patients treated with single-level osteotomy and bone transfer combined with intramedullary nail were used as the trial group. Thirty patients treated with single-level osteotomy and bone transfer were used as the control group. After treatment, follow-up was carried out by the combination of outpatient follow-up, phone call and Wechat video. The mineralization time of regeneration area, healing index, external fixation time, external fixation index, joint healing, needle infection, and refracture were compared between the two groups. The scoring standard of Association of Study and Application on Method of Ilizarov was used to evaluate the bone healing and function.
RESULTS AND CONCLUSION: (1) The patients in both groups were followed up for (31.0±7.3) months. The incision had no redness, swelling, or pain, and needle tract infection were controlled after removal of the outer frame. (2) There was no significant difference in mineralization time, healing index, refracture rate, and joint healing between the two groups (P > 0.05). The external fixation index was smaller in the trial group than that in the control group (P < 0.05). Number of patients with bone end cleaning and bone grafting was smaller in the trial group than that in the control group (P < 0.05). The rate of needle tract infection was lower in the trial group than that in the control group (P < 0.05). (3) ASAMI score was better in the trial group than that in the control group (P < 0.05). (4) It is concluded that compared with the single-level osteotomy and bone transfer, single-level osteotomy and bone transfer combined with intramedullary nail in the treatment of tibial bone defect can shorten the fixator time, reduce the probability of postoperative debridement and replantation of bone compression, and avoid needle tract infection.

Key words: intramedullary nail, bone transfer, Ilizarov technique, tibial bone defect, circular external fixator, healing index, external fixation index, docking site

CLC Number:

Tu Zhenxing, Wang Bin, Lu Aidong, Zhang Dingding, Yang Huanyou, Wang Hui, Wang Wei, Gong Zhongping, Li Ligeng. Single-level osteotomy and bone transfer combined with intramedullary nail in the treatment of tibial bone defect[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(12): 1849-1853.

Figures/Tables 5

References

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