Yin Qudong, Sun Zhenzhong, Gu Sanjun, Wei Xuming, Song Sheng, Ma Yunhong
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Dec;27(12):1462-5.
To investigate the effectiveness of shortening-lengthening method using Ilizarov technique for repairing large tibial bone and soft tissue defects.
Between January 2006 and December 2011, 12 patients with large tibial bone and soft tissue defects were treated by shortening-lengthening method using Ilizarov technique. There were 8 males and 4 females with an average age of 39.3 years (range, 18-65 years). The causes were injury in 8 cases and chronic infection in 4 cases. The area of soft tissue defect was 5 cm x 4 cm to 20 cm x 16 cm, and the length of tibial bone defect was 4.5-8.0 cm with an average of 6.2 cm.
Incision in the lengthening area healed by first intention; healing of wounds by first intention was achieved in 6 cases, delayed healing in 2 cases, and secondary healing in 4 cases, with no common peroneal nerve injury. All patients were followed up 18-54 months with an average of 29 months. In the lengthening area, the bone healing time was 180-365 days (mean, 267 days), and the healing index was 3.8-4.3 days/mm (mean, 4.1 days/mm). In the shortening area, the bone healing time was 195-380 days (mean, 297 days) in the others except 1 case who was repaired with bone grafting. Mild pin-related infection and loosening were observed in all cases, but no infection occurred in the lengthening or shortening area. At last follow-up, weight bearing of the leg was fully recovered in 12 cases. According to Mazur's criteria, the function of ankle was excellent in 2 cases, good in 6 cases, and fair in 4 cases. Nine patients had equal limb length, and 3 patients had shortened length less than 2 cm.
Shortening-lengthening method using Ilizarov technique has the advantages of simple surgery, less complications, easy to close the wound, and good effectiveness in repairing of large tibial bone and soft tissue defects.
探讨应用伊里扎洛夫技术采用短缩延长法修复胫骨大段骨与软组织缺损的疗效。
2006年1月至2011年12月，对12例胫骨大段骨与软组织缺损患者采用伊里扎洛夫技术短缩延长法治疗。男8例，女4例，平均年龄39.3岁（18 - 65岁）。病因：外伤8例，慢性感染4例。软组织缺损面积为5 cm×4 cm至20 cm×16 cm，胫骨骨缺损长度为4.5 - 8.0 cm，平均6.2 cm。
延长区切口一期愈合；6例伤口一期愈合，2例延迟愈合，4例二期愈合，无腓总神经损伤。所有患者随访18 - 54个月，平均29个月。延长区骨愈合时间为180 - 365天（平均267天），愈合指数为3.8 - 4.3天/mm（平均4.1天/mm）。短缩区，除1例行植骨修复者外，其余患者骨愈合时间为195 - 380天（平均297天）。所有病例均观察到轻度的针道相关感染和松动，但延长区和短缩区均未发生感染。末次随访时，12例患者下肢负重完全恢复。根据马祖尔标准，踝关节功能优2例，良6例，可4例。9例患者肢体等长，3例患者肢体短缩小于2 cm。
应用伊里扎洛夫技术的短缩延长法修复胫骨大段骨与软组织缺损具有手术操作简单、并发症少、伤口易闭合、疗效好等优点。
