Management of post-traumatic bone defects of the tibia using vascularised fibular graft combined with Ilizarov external fixator
Autor: | Mohammad Hasan, Ahmad El-Sayed Semaya, Ehab Badawy, Ramy Mohammad El-Nakeeb |
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Rok vydání: | 2015 |
Předmět: |
Adult
Male medicine.medical_specialty External fixator Adolescent External Fixators medicine.medical_treatment Bone healing medicine.disease_cause Surgical Flaps Weight-bearing Weight-Bearing 03 medical and health sciences External fixation Young Adult 0302 clinical medicine Iliac bone medicine Humans Bone transport Tibia Fibula Child General Environmental Science Aged 030222 orthopedics Bone Transplantation business.industry 030229 sport sciences Middle Aged Plastic Surgery Procedures Limb Salvage Surgery Tibial Fractures Treatment Outcome General Earth and Planetary Sciences Female business Follow-Up Studies |
Zdroj: | Injury. 47(4) |
ISSN: | 1879-0267 |
Popis: | Introduction Post-traumatic bone defects of the tibia present a difficult reconstructive challenge. Various methods of reconstruction are available, such as allografts, vascularised fibular graft (either free or pedicled) and bone transport technique. Patients and methods Fourteen patients with an average age of 34.1 years at operation (range, 12–65) with post-traumatic bony defects of the tibia were selected for reconstruction with vascularised fibular graft combined with Ilizarov external fixation. There were 12 male and two female. The size of the bony gap was 10.4 cm (range, 7–13) and the average length of the fibula used was 16.4 cm (range, 14–21). Results The mean follow up period was 20.4 months (range, 10–37). All patients had bony union at both proximal and distal ends of the fibula primarily except one patient that required secondary iliac bone graft at the distal end of the fibula to obtain union. The average time for bone healing was 3.9 months (range, 3–9). The average time spent in Ilizarov frame was 5.9 months (range, 5–11). Unprotected full weight-bearing was achieved within an average of 7.3 months (range, 6–12). Conclusion Vascularised fibular bone graft combined with an Ilizarov frame is a successful approach to safely and effectively reconstruct bone defects of the tibia. It has the advantages of vascularised fibular bone grafts together with the biomechanical advantages of Ilizarov frame that allows weight bearing to start almost immediately after surgery. This leads to a good outcome regarding the union and function. |
Databáze: | OpenAIRE |
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