External fixation of the lower extremities: Biomechanical perspective and recent innovations.

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Abstract

[Indexed for MEDLINE] 16. BMC Musculoskelet Disord. 2023 Nov 7;24(1):864. doi: 10.1186/s12891-023-06955-0. Complications analysis of Ilizarov bone transport technique in the treatment of tibial bone defects-a retrospective study of 199 cases. Feng D(#)(1), Zhang Y(#)(2), Jia H(1), Xu G(3), Wu W(4), Yang F(2), Ding J(2), Li D(1), Wang K(1), Luo Y(1), Liu X(1), Guo Q(1), Zong Z(5). Author information: (1)Department of Pain, The First Affiliated Hospital of Hebei North University, Zhang Jiakou, Hebei, China. (2)International Medical Services, The First Affiliated Hospital of Hebei North University, Zhang Jiakou, Hebei, China. (3)Department of Otolaryngology and Head Surgery, The First Affiliated Hospital of Hebei North University, Zhang Jiakou, Hebei, China. (4)Department of Pathology, The First Affiliated Hospital of Hebei North University, Zhang Jiakou, Hebei, China. (5)Department of Joint Surgery, The First Affiliated Hospital of Hebei North University, Zhang Jiakou, Hebei, China. 838882616@qq.com. (#)Contributed equally BACKGROUND: The clinical treatment of long bone defets in the extremities caused by trauma, infection, tumours, and nonunion has been a challenge for orthopaedic surgeons. Bone transport techniques have become the only way to treat such bone defects. However, inevitable difficulties and complications related to bone transport techniques have been reported in many studies. AIM: The purpose of this study was to investigate the risk factors for complications and the effectiveness of the Ilizarov bone transport technique in the treatment of tibial bone defects. METHODS: The study was conducted in 199 patients who underwent treatment with the Ilizarov bone transport technique at our institution from May 2012 to September 2019. Patient demographic data, complications and clinical outcomes after a minimum of 2 years of follow-up were collected and retrospectively analysed. Additionally, a risk factor analysis was performed for the top three major complications. The clinical outcomes were evaluated using the Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria at the last clinical follow-up. RESULTS: A total of 199 patients underwent follow-up for 12-40 months, with an average of 23.5 months, and all achieved bone healing. A total of 310 complications occurred, with an average of 1.04 minor complications and 0.48 major complications per patient. The top three complications were pin tract infection in 48 cases (61.3%), axial deviation in 86 cases (43.2%), and delayed union in 50 cases (25.13%). Multivariate analysis showed that the bone defect length (P = 0.02, OR = 5.489), the number of previous surgeries (P = 0.003, OR = 2.204), and the external fixation index (P = 0.01, OR = 1.202) were significantly correlated with pin tract infection. Bone defects of the middle 1/3 (P