Presentation and outcome of femoral infected non-unions in children and adolescents.

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Abstract

Conflict of interest statement: Conflicts of Interest: None. 20. Ther Clin Risk Manag. 2025 Sep 17;21:1369-1382. doi: 10.2147/TCRM.S525768. eCollection 2025. Clinical Outcomes of Ilizarov Bone Transport for Distal Tibial Defects in Refractory Osteomyelitis: A Retrospective Study. Alimujiang A(#)(1), Jia Q(#)(1), Guo J(1), Zhang J(1), Wang X(1), Zhao M(1), Ouzhabayier M(2), Wang Y(3), Ma C(1). Author information: (1)Department of Trauma Orthopedics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China. (2)Department of Rehabilitation Medicine, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China. (3)College of Chemical Engineering, Xinjiang Normal University, Urumqi, Xinjiang, People's Republic of China. (#)Contributed equally BACKGROUND: Distal tibial defects following refractory osteomyelitis pose a significant orthopedic challenge, necessitating effective reconstruction. The Ilizarov bone transport technique is a potential treatment option, but its clinical outcomes specifically for distal tibial infectious defects need further evaluation. METHODS: In this retrospective observational single-arm study, we analyzed the clinical data of 22 patients who had undergone multiple debridements for refractory distal tibial osteomyelitis (DTO) and had associated bone defects, and were subsequently treated with the Ilizarov bone transport technique. Following debridement surgery, bone transport treatment was administered. Regular X-ray examinations, rehabilitation guidance, and follow-up were conducted to assess infection control, bone healing, limb function recovery, and complications. Therapeutic effects were evaluated using the Association for the Study and Application of Methods of Ilizarov (ASAMI), Visual Analog Scale (VAS) score, Activities of Daily Living (ADL) score, and American Orthopaedic Foot & Ankle Society (AOFAS) score improvement. RESULTS: The mean follow-up was 29.32±20.92 months, with an average of 3.77±1.83 debridements. All bone defects healed, though 5 patients later required ankle arthrodesis. Complications included pin tract infection (n=10), axial deviation (n=3), ankle joint stiffness (n=2), non-union at the docking site (n=2), and delayed consolidation (n=2). At the last follow-up, ASAMI bone results: 15 excellent, 5 good, 2 poor (90.9% superiority rate). ASAMI functional results: 6 excellent, 14 good, 1 fair, 1 poor (90.9% superiority rate). VAS decreased from 4.86±0.83 to 0.5±0.66 (p