Treatment of the Tibial Infected Nonunion with Large Defects Using the Ilizarov Method in 13 Patients

Objective To evaluate the treatment of tibial infected nonunion with large defects using the Ilizarov method associated with bone segment transport and lengthening. Methods From January 2009 to October 2013,13 patients suffered tibial infected nonunion with large defects underwent operation in our hospital. After debridement,the mean bone defect length was 9( 5 to 16) cm. The mean soft tissue defect after debridement was 5 cm × 8 cm to 10 cm × 10 cm. All 13 cases underwent subperiosteal osteotomy in the primary stage. The bone segments were transported 7 days following osteotomy and proceeded at a rate of 0. 25 mm every 6 hours. Results All the patients were followed up for 5 to 24 months with an average of 16. 2 months,bony healing was obtained in all cases,the average fixation time was from 16. 2 months( range from 8 to14 months). Among them,there was 1 case suffered pin tract infections,there was still secretion from the end of bone in 1patients and lack of blood supply to abutting ends in two patients,there was bone segmental axial deviation in 1 patients. All patients with complications underwent the corresponding treatments and achieved good results. Conclusion It is an easy and effective way to treat the tibial infected nonunion with large defects using the Ilizarov method associated with bone segment transport and bone lengthening.