Abstract
Introduction: The management of post-traumatic, tibial, segmental, skeletal defects is a difficult problem that often requires complex approaches for successful limb salvage. Bone transport and acute shortening with subsequent relengthening are two techniques that have been made possible using Ilizarov’s methods.
Aim: To determine whether either technique offers any intrinsic advantage relative to the other.
Methods: We carried out a retrospective review of charts and radiographs of 42 patients with post-traumatic tibial defects that had been managed using Ilizarov’s methods. The follow-up period averaged 26 months. We selected patients with defects between 3 cm and 10 cm to provide a suitable comparison. The patients were divided into two groups of 21 each, treated either by bone transport or acute shortening.
Results: The defects averaged 7.0 cm in the transport group and 5.8 cm in the acute shortening group. The transport group averaged 12.5 months in the fixator; the acute shortening group averaged 10.1 months. However, the external fixation index was virtually identical in the two groups (mean 1.8 months/cm in the transport group and 1.7 months/cm in the acute shortening group). The complication rate, radiographic results, and functional results were slightly better in the acute shortening group.
Conclusions: Both techniques demonstrated excellent results overall and the external fixation index was nearly identical for these related methods. The final results after treatment by acute shortening were found to be slightly better than the final results following bone transport. There may be a slight advantage to the use of this technique for smaller defects in properly selected patients.
The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand
