Ilizarov bone transport in large bone loss and in severe osteomyelitis

Eleven patients, 21-53 years of age, were treated for large tibial (9), femoral (1), or humeral (1) bone loss (4-16 cm) by the Ilizarov technique of external or internal bone transport. Bone defects were closed from within. Bone grafts were not used; instead, a free bone fragment was moved gradually internally by distraction to fill the defect. In cases of severe osteomyelitis, a large fragment (up to 16 cm) of affected bone was resected and the defect was filled by the same technique. Seven patients had external bone transport, three patients had internal bone transport, and one patient had combined external-internal bone transport. The duration of treatment was 5-28 months (mean, 12 months). Excellent results were achieved in eight patients, good results in two patients, and a fair result in one patient. Complications included two fractures of regenerated bone as a result of a second trauma, one 3-cm shortness of a limb, one development of foot equinus, and one incidence of transient peroneal nerve palsy.