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.
Key words
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“Accordion” technique /
Bone defect /
Bone transport /
Tibia
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