[Accordion operation for the bone transport in treating tibial bone defect]

Area of Science:

• Orthopedic surgery
• Regenerative medicine
• Biomechanical engineering

Background:

• Tibial bone defects pose significant challenges in orthopedic treatment.
• The Ilizarov technique is a widely used method for limb reconstruction.
• Optimizing bone healing and functional recovery remains a key objective.

Purpose of the Study:

• To evaluate the clinical outcomes of the "accordion operation" as an adjunct to the Ilizarov technique for treating tibial bone defects.
• To compare the efficacy of the accordion operation versus standard Ilizarov bone transport in terms of healing time, bone healing index, and functional recovery.

Main Methods:

• A prospective study involving 22 patients with tibial bone defects treated with the Ilizarov bone-transport technique.
• Patients were divided into two groups: 11 treated with the "accordion operation" post-bone transport and 11 in a control group with standard external fixator locking.
• Follow-up duration ranged from 18 to 36 months, with assessment using Paley's criterion for bone healing and functional outcomes.

Main Results:

• All patients achieved bone healing. The accordion group showed a significantly improved bone healing index (46.2±3.5 d/cm) compared to the control group (57.8±3.5 d/cm) (P=0.000).
• Bone healing time was comparable between groups (365±91 days vs. 435±108 days, P=0.115).
• Functional outcomes (Paley's criterion) were excellent in 9 cases (accordion) vs. 8 cases (control) and good in 2 vs. 3 cases, with no significant difference (P=0.619). Complication rates were similar between groups.

Conclusions:

• The "accordion operation" enhances the Ilizarov technique for tibial bone defects by improving the bone healing index.
• This technique may lead to shorter consolidation times and improved treatment efficiency.
• The accordion operation is a viable adjunct for optimizing outcomes in tibial defect reconstruction.