[Tibial pseudoarthrosis. Treatment using the Ilizarov technique]

In the period from the 1.1.1991 to the 31.5.1993 17 patients with a tibial pseudoarthrosis were treated by the Ilizarov method. The mean age was 35 years (13-88 years). Mean time from fracture to operation for pseudoarthrosis was 14.6 months (3-39 months). There were two hypertrophic, 14 atrophic and one defect pseudoarthrosis. Six of the pseudoarthroses were infected. After stable external fixation the treatment was compression over the pseudoarthrosis in four cases and alternating distraction and compression in eight cases. In five cases the treatment was supplemented by bone transport for the defects between 15 and 50 mm. Mean time of treatment with the external fixator was 5.2 months (2-11.5 months). The overall treatment time was 9.8 months (3-19 months). At the follow-up 14 pseudoarthroses were fully consolidated, one patient was still using an orthosis, and three patients were in need of reoperation with bone transplantation. During the period of fixation thirteen patients were hospitalized for short periods, and some of them several times. The treatments were for correction of the distraction, replacement of fixation of pintrack infection or treatment of pain. The Ilizarov method of treatment of pseudoarthrosis show a good stimulation of healing, but experience with the fixator system and aggressive treatment of various minor complications are essential for a successful outcome.