ABSTRACT
OBJECTIVE@#To analyze effect of accordion technique on bone mineralization of extended bone segment in treating tibial bone defect with bone transport.@*METHODS@#From May 2017 to October 2019, 22 patients with tibial bone defects were treated with Ilizarov bone-transport technique, and divided into two groups after bone-transport was completed, 11 patients in each group. In observation group, there were 9 males and 2 females aged from 20 to 60 years old with an average of (42.6± 13.3) years old;the length of bone defect ranged from 3 to 13 cm with an average of(6.4±2.6) cm;2 patients were suffered from upper tibial bone defects, 3 patients were middle and 6 patients were lower;patients were treated with accordion technique for 35 days. In control group, there were 10 males and 1 female aged from 41 to 60 years old with an average of (51.6±6.4) years old;the length of bone defect ranged from 3 to 10.7 cm with an average of (6.6±2.5) cm;1 patient was suffered from upper tibial bone defects, 3 patients were middle and 7 patients were lower;patients were treated with lock external fixator to waiting bone mineralization. The content of hydroxyapatite (HAP) extended bone segment was measured after bone-transport completed immediately, 35, 65 and 95 days after bone-transport was completed, respectively, then the mineralization time and healing time were compared between two groups, and the therapeutic effect of bone defect was evaluated by using Paley scoring criteria.@*RESULTS@#Twenty-two patients were followed up from 18 to 36 months with an average of (27.0±6.3) months. The wounds on the bone defects healed spontaneously during bone transport, and there were no wound complications such as skin infection or skin necrosis occurred. There were statisticaldifference in the content of HAP of the extended bone segments at 35, 65 and 95 days after bone-transport between two groups (@*CONCLUSION@#Accordion technique and locking external fixator mineralization in prolonging bone segment healing after bone-transport have the equal clinical effect, while the accordion technique could significantly accelerate the growth rate of HAP and shorten the mineralization time and healing time.
Subject(s)
Adult , Aged , Female , Humans , Infant, Newborn , Male , Middle Aged , Young Adult , Calcification, Physiologic , External Fixators , Ilizarov Technique , Tibia/surgery , Tibial Fractures , Treatment OutcomeABSTRACT
BACKGROUND: Ilizarov technique has obvious advantages in the treatment of tibial bone defect and can be used to treat various types of tibial bone defect. However, there are still many shortcomings in this technology, which need to be solved urgently. OBJECTIVE: To review the advantages, shortcomings and improvement strategies of Ilizarov technique in the treatment of tibia bone defect. METHODS: PubMed, CNKI and Wanfang databases from 1971 to 2019 were retrieved with the key words of “bone defect, bone transport, accordion maneuver, ultrasonography, energy spectrum CT, pin site infection” in English and Chinese, respectively. Totally 57 eligible articles were included to systematically summarize the advantages, shortcomings and improvement strategies of Ilizarov technique in the treatment of tibia bone defect. RESULTS AND CONCLUSION: (1) Ilizarov technology has obvious advantages in the treatment of the tibia bone defect, combined with soft tissue injury, infection and deformity of the tibia bone defect. (2) New disinfectants, accordion technology, color Doppler ultrasound and energy spectrum CT are effective treatment methods for complications of bone transport technology, such as pin site infection, poor mineralization of new bone in the transfer area, and difficulty in healing at the docking site. These methods can reduce the incidence of complications. (3) It is still necessary to improve the existing treatment techniques or choose new methods to further reduce the incidence of complications.