Abstract:

Objective

To demonstrate the clinical efficacy of Ilizarov ring external fixator combined with bone moving technique in treating severe tibial open comminuted fractures.

Methods

14 cases of severe Gustilo ⅢB tibia fractures admitted to Department of Trauma Orthopedics， Yuebei People's Hospital Affiliated to Shantou University from January 2019 to December 2022.Emergency surgery to crush the nonvital bone block， plate or Kirschner wire to fix the fibula， using Ilizarov ring external holder to fix the tibia.After debridement， the tibia was over 6.5 cm.The time of bone segment removal and fracture-end healing were recorded by regular follow-up after operation.Johner-Wruhs criteria were used to assess the function of the affected limb and Kofoed criteria to assess the function of the ankle joint.

Results

The average follow-up time for 14 patients was 14.50（11-23）months.The average time of relocation is 4.39（3-8）months and the average time of bone healing is 11.50 months.All the wounds healed well after bone migration， and the fracture end healed after autologous bone grafting and compression.In 2 cases， axial deviation of the displaced bone segment， and recovery after timely adjustment of the external fixator.2 cases showed osteogenesis insufficiency and healing after bone grafting.The Johner-Wruhs criteria showed 11 excellent and 3 good.And ankle functions showed 11 excellent， 2 good and 1 pass.

Conclusion

Ilizarov bone transfer technique yields benefits for tibia fracture with severe long open comminuted fracture， few operation times， short duration and good clinical effect.

Key words: Tibial fracture, Fractures，open, Bone transfer, Ilizarov annular external fixation, Distraction osteogenesis