Open segmental tibial bone defects treated with Ilizarov frame: a radiological and functional outcome study with average ten year follow-up.

Abstract

Surgical reconstruction of large post-traumatic tibial bone and soft tissue defects following high-energy trauma presents a significant challenge for orthopaedic surgeons. This study aimed to evaluate the functional and radiological outcomes of large post-traumatic tibial bone and soft tissue defects managed by single or double-level bone transport using the Ilizarov technique. 13 patients who underwent treatment for large tibial bone defects (Gustillo IIIa, IIIb, IIIc) along with soft tissue defects with Ilizarov from 2010 to 2020A.D were included. ASAMI functional and radiological outcomes were assessed at the final follow-up to report the outcome. The mean age was 27.38 (18-48). An average bone defect was 7.69cm (5-13cm). Based upon the Gustillo-Anderson classification (GA), 2 (15%) of them were GA - 3A, 7 (54%) were GA - 3B, and 4 (31%) were GA - 3C. The average time of distraction was 11.76 weeks (8-16). The average time for the union was 37 weeks (27-48 weeks). The average bone lengthening was 7.69cm (5-13cm). The mean final leg length discrepancy (LLD) at the final follow-up was 1.96cm (0-4cm). The primary union was achieved in eight cases, and five required bone grafting at the docking site. Using the ASAMI (Association for the Study of the Method of Ilizarov) scoring system, the functional results were excellent in six and good in seven cases, while the bony results were excellent in eight, good in four and fair in one case. Good to excellent functional and radiological scores (ASAMI) can be expected when using the Ilizarov frame for simultaneous treatment of the large tibial bone and soft tissue defect when this method is applied with correct principles.