Treatment of tibial transport gap fracture after bone transport by external fixation with locking compression plate and autologous iliac grafting
10.3760/cma.j.issn.1671-7600.2017.12.015
- VernacularTitle:锁定加压钢板外固定结合自体髂骨植骨治疗胫骨骨搬运后搬移间隙骨折
- Author:
Yiyang LIU
1
;
Lifeng SHEN
;
Chun ZHANG
;
Qiaofeng GUO
;
Bingyuan LIN
;
Kai HUANG
;
Ning LU
;
Gouping MA
;
Lifeng ZHAI
;
Zhan ZHANG
Author Information
1. 浙江省立同德医院骨科
- Keywords:
Tibia;
Bone plates;
External fixators;
Bone grafting;
Bone transport
- From:
Chinese Journal of Orthopaedic Trauma
2017;19(12):1088-1092
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the curative efficacy of treating tibial transport gap fracture after bone transport by external fixation with locking compression plate(LCP) and autologous iliac grafting.Methods From February 2015 to January 2016,9 patients who had sustained tibial transport gap fracture after bone transport were treated by LCP external fixation and autologous iliac grafting.They were 7 men and 2 women,aged from 26 to 56 years (average,40.2 years).One of them received bone transport because of limb shortness after replantation and others did because of traumatic osteomyelitis.The distances of tibial transport averaged 9.2 cm (from 7 to 12 cm);the time for external fixation averaged 20.1 months (from 13 to 25 months);the time from removal of external fixator to gap fracture averaged 1.8 weeks (from 1 to 3 weeks).Two patients were complicated with docking site fracture.The durations from gap fracture to operation averaged 4.1 days (from 3 to 5 days).Five patients sustained angular deformity of various severities which could not be corrected by surgery.The curative efficacy was evaluated according to conventional criteria for fracture healing.Results The 9 patients were followed up for 11 to 15 months (average,13.1 months).The time for LCP external fixation averaged 9.0 months (from 8 to 10 months);the time for fracture union averaged 4.6 months (from 4 to 5 months).The 5 patients with angular deformity obtained fracture malunion which did not obviously affect their limb appearance.One case suffered extensive cellulitis at the leg which responded to intravenous administration of antibiotics.No pin track infection happened.The knee and ankle functions after removal of LCP external fixation were not significantly different from those after removal of external fixator following bone transport.Wounds at the iliac donor site and bone graft area all healed well.Conclusions LCP external fixation is an effective treatment for tibial transport gap fracture after bone transport,due to its stable fixation,limited injury to soft tissues,positive curative efficacy and miniature size as well.However,it requires sophisticated operative skills and demanding postoperative care.
