Ilizarov technique for one-stage treatment of tibial defect and equinus deformity

Abstract

Objective To report one-stage treatment of tibial defect and equinus deformity using Ilizarov technique.Methods From January 2005 to January 2012,we used Ilizarov technique to treat 17 cases of traumatic,infected or iatrogenic tibial defect and equines deformity at one stage.They were 12 men and 5 women,aged from 12 to 47 years (average,29.0 years).All cases were unilateral,with a bone defect of 1.5 cm to 14.0 cm (average,7.3 cm).The complicated foot drop deformity ranged from 20° to 50° (average,37°).Osteomyelitis was complicated in 4 cases.Bone transport was started one week after operation with a speed of 1 mm/d and completed in 4 to 6 times.Simultaneously,the adjustment of external fixator was performed to correct the foot equines deformity with a speed of 2 to 3 mm/d and completed in 3 to 4 times.Results The 17 cases were followed up for a mean duration of 33.0 months (from 12 to 70 months).The external fixation time ranged from 7 to 27 months (mean,14.0 months).No postoperative infection was observed.The lower limb mechanical shaft was restored to normal in all cases.The limb disparity was ＜ 2 cm.At the last follow-up,by Paley's criteria for nonunion treatment,the therapeutic outcomes were rated as excellent in 9 cases and good in 8.The equines deformity was corrected at the primary stage in all cases.The American Orthopaedic Foot & Ankle Society(AOFAS) scores ranged from 85 to 96 points (average,92.0 points).Slight foot drop was observed in 3 cases,with an ankle range of motion of ＜ 15°.Conclusions Ilizarov technique can be used to treat at one stage patients with tibial defect and equines deformity.It can allow for early weight-bearing exercise,shorten the treatment cycle and lead to satisfactory outcomes for the patients. Key words: Tibia; Ankle joint; Clubfoot; Ilizarov technique