目的　探讨“手风琴”技术对Ilizarov骨搬运治疗骨缺损疗效的影响。  方法　回顾性分析2013年12月~2017年2月本院采用Ilizarov骨搬运技术治疗大段胫骨骨缺损的29例患者资料。随机分为两组，两组患者的性别、年龄、骨缺损长度、手术次数、骨搬运术前邻近关节评分等情况，差异均无统计学意义。观察外固定时间、骨愈合时间、骨愈合分级、术后并发症和下肢功能恢复等。  结果　患者均安全度过围手术期，随访时间20~40个月，平均24.3个月。对照组（15例）骨愈合时间为（14.35±3.39）个月，“手风琴”组（14例）为（12.56±2.80）个月，两组骨愈合时间比较差异有统计学意义。对照组骨愈合分级优8例，良4例，优良率为80%；“手风琴”组优7例，良5例，优良率为85.7%，“手风琴”组好于对照组，但差异无统计学意义（P＞0.05）。“手风琴”组的并发症发生率少于对照组，差异有统计学意义（P＜0.05）。对照组下肢功能恢复分级优7例，良6例，优良率为86.7%；“手风琴”组优8例，良5例，优良率为92.8%，差异无统计学意义。对照组外固定时间为（15.15±2.86）个月，“手风琴”组为（14.09±2.23）个月，差异无统计学意义（P＞0.05）。  结论　通过“手风琴”技术可以缩短对合端骨愈合时间、提高愈合率和减少并发症，对肢体功能恢复有一定的积极作用，应重视其在骨搬运技术中的重要性。

Objective　To investigate clinical effects of ‘accordion’ technique on the treatment of  large segmental tibial bone defects by Ilizarov bone transport technique.　Methods　The clinical data of 29 patients admitted to our hospital treated with large segmental tibial bone defects using Ilizarov bone transport technique were retrospectively analyzed. These patients were randomly divided into two groups. There was no statistically significant difference between the two groups in gender, age, length of bone defect, operation frequency, preoperative adjacent joint score before bone transport. External fixation time, healing time, healing grade and complications after surgery and function recovery of the lower limb were analyzed.　Results　All patients experienced no or minor complications during the perioperative period, then recovered completely. Follow up about 20~40 months, with a mean value of 24.3 months. The bone healing time of the control group was（14.35±3.39）months while that of the “accordion” group was（12.56±2.80）months , there was statistical difference in the bone healing time between the two groups. Bone healing grade in the control group: 8 cases were excellent, 4 cases good, overall good rate was 80%. Bone healing grade in the “accordion” group:  7 cases excellent, 5 cases good, overall good rate was 85.7%. Bone healing grade of “accordion” group was better than that of control group, but there was no statistical difference(P>0.05). The complication rate of “accordion” group was lower than that of the control group, there were statistical differences in the complication rate between the two groups. Lower limb function recovery in the control group: 7 cases were excellent, 6 cases good, with an overall good rate of 86.7%. While for that in the “accordion” group, 8 cases were excellent, 5 cases good, the overall good rate was 92.8%. The external fixation time of the control group was (15.15±2.86) months while that of the accordion group was (14.69±2.23) months, there was no statistical difference in the external fixation time (P>0.05).　Conclusions　“Accordion” technology can shorten the time of bone healing at the union end, improve the rate of natural healing rate and reduce complications of surgeries, which plays a positive role in the recovery of limb function.It is worthy of our attention on its application in clinical practice.