[Segmental displacement by callus distraction in extended tibial defects]

Area of Science:

• Orthopedic Surgery
• Traumatology
• Regenerative Medicine

Background:

• Spongiosaplasty is insufficient for open tibial fractures with large defects (>4 cm).
• Ilizarov's callus distraction principles offer a potential solution for significant bone defects.

Purpose of the Study:

• To evaluate the efficacy of Ilizarov's callus distraction combined with modern fixation for severe tibial defects.
• To assess limb salvage rates and treatment outcomes in complex tibial fracture cases.

Main Methods:

• Ilizarov's callus distraction technique combined with external fixation and AO/ASIF implants.
• Treatment of 15 patients with severe tibial fractures (average defect 7 cm) between 1988 and 1995.
• Average of 5.3 operations per patient, with a median treatment duration of approximately 1 year.

Main Results:

• Successful bone regeneration, producing over 1 meter of tubular bone across all patients.
• Excellent or good final outcomes in all treated patients, avoiding amputation.
• High complication rate (53%) but successful limb salvage in severe open fractures and post-malignancy defects.

Conclusions:

• Ilizarov's method is a viable and cost-effective treatment for extensive tibial bone defects, offering limb salvage.
• Patient compliance is crucial for successful outcomes; lack of compliance is a contraindication.
• This technique provides a realistic chance for physical integrity and mobility in challenging orthopedic cases.