[Prevention and treatment of the related complications of tibial fractures bone defect by bone transport].

OBJECTIVE

To explore the therapeutic methods for the prevention and treatment of tibial bone defect and bone transport related complications.

METHODS

From January 2012 to June 2015, 38 cases of bone defect of tibia were treated by bone transport technique treatment, including 26 males and 12 females, with an average age of 49.0 years old ranging from 36 to 66 years old. All patients were open fractures. The length of bone defect of 38 patients was 4 to 9.6 cm with an average of 5.2 cm. The force line and bone carrying rate were adjusted in time after operation. Patients insisted on loading.

RESULTS

All patients were followed up for 17 to 36 months with an average of 24 months. Among them, 19 patients got natural healing in involution end;the other 18 cases respectively got healing after accordion technology in 10 cases, auxiliary internal fixation of bone graft after corresponding processing in 8 cases, 1 patient for dottiness, pneumonia, the knee joint dislocation, diabetes, cerebral palsy sequela was difficult to care, patients' families urged amputation surgery, so the amputation processing. The time of moving the bone transport was 4 to 10 months with an average of 7.1 months. Move length was 5 to 11.6 cm with an average of 8.0 cm. According to tibial stem diagnostic criteria of Johner-Wruhs score, 11 cases were excellent, 18 cases were good, 6 cases were moderate and 3 cases were poor. In addition to 1 case of amputation, the remaining cases were cured, no infection recurrence, re fracture and so on.

CONCLUSIONS

Bone transport method is an effective method for the treatment of bone defect of tibia, but the existence of many complications is to limit the clinical application of the main factors, including shifting when the distance is too long the long reprojected line offset (bone exposure), nail tract infection, pin loosening, subsidence of soft tissue, loss of function of knee and ankle joint, pull a callus is not long, the contact ends were nonunion.