Objective To investigate the clinical effect of tibial bone defects treated with bone transport of external fixation combined with intramedullary nail. Methods From January 2012 to May 2020, data of 58 patients with tibial bone defects treated with bone transport were retrospectively analyzed. According to different treatment methods, they were divided into an external fixation group (traditional group, 40 cases) and an external fixation with intramedullary nail fixation group (combined group, 18 cases). There was no statistical difference between the two groups in gender, age, course of disease, length and type of bone defect, combined injury, number of operations and score of adjacent joints before bone handling (P>0.05). The wound healing, bone healing, external fixation time, healing index, lower limb functional recovery, complications, physical and mental health were compared. Bone healing and functional recovery of lower extremity were evaluated according to ASAMI. The complications of Ilizarov technique were classified into major and minor complications according to Paley method. The physiological function (PCS) and mental health quality (MCS) were evaluated respectively by item short form health survey (SF-36). Results All patients were followed up for 16 to 40 months, with an average of 25.5 months. The external fixation time, bone healing time, postoperative major complications, minor complications and MCS in the combined group were significantly better than those in the traditional group (P<0.05). There was no significant difference in incision healing, healing index, lower limb functional recovery and PCS (P>0.05). Conclusions External fixation with intramedullary nail fixation for tibial bone defects can avoid poor alignment and malunion, significantly reduce the external fixation time, complications and adverse effects on mental health.
Key words
Tibia; /
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Bone defect; /
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Bone transport; /
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Intramedullary nail; /
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Complication
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