Aims: To evaluate the results and complications of Ilizarov bone transport method for the treatment of long bones defects. Methods: Between 1990 and 2001 the Ilizarov intercalary bone transport method was applied to treat 44 patients with segmental bone loss of the femur and tibial. The series comprised 30 males and 14 females with an average age of 33 years (range 17–68 years). Two different types of treatment were used: Ç monofocal È technique, for small bone defects up to 4 cm and Ç bifocal È technique, for large bone defects (4–20 cm). The mean bone defect was 10 cm (range 3–18cm), while mean external þxation time was 8.6 months (range 3–24 months). The mean consolidation index of the distraction gap was 23 days/cm (range 18–27 d/cm). Mean follow up period after frame removal was 4 years (range 1–11 years). Results: The bone results were rated as excellent in 33 patients (74%), good in 6 (13%) and poor in 1 (2%). The functional results were rated as excellent in 7 patients (16%), good in 29 (66%), fair in 5 (11%), and poor in 3 (7%). Pin tract infection was the most common complication. The late complications included axial deformities, re-fractures and joint stiffness. Conclusions: The Ilizarov method is still an effective technique for bone defects treatment; the main disadvantage is the prolonged external þxation time.

The purpose of this study is to evaluate the results of the treatment of displaced greater-tuberosity fractures by open reduction and stable fixation with heavy non absorbable sutures and early passive motion. Thirty-six patients, 21 male (average age 50 years) and 15 female (average age 62 years) underwent open reduction and internal fixation for a displaced greater-tuberosity fracture of the proximal humerus, between 1992–2000. Main indication for operative treatment was at least 1 cm displacement of the tuberosity. Reduction and stable fixation of the greater tuberosity with its rotator-cuff attachments, was performed by a lateral approach using heavy transosseous nonabsorbable sutures. Passive motion was started at the second postoperative day followed by active range of motion after the fifth postoperative week.

All patients were examined periodically using clinical and radiological criteria. All fractures were healed without any displacement within 3 months. Final assessment was performed according to Neer’s criteria for pain, motion, function, strength and patient’s satisfaction, in a mean follow-up period of 4 years. Twenty seven patients (75%) rated excellent, without pain, showing active forward elevation at 160 to 180°, external rotation at 60 to 80° and internal rotation up to tiq level. Nine patients (25%) rated very good, had only minor pain problems.

We conclude that, if displaced fractures of the greater tuberosity are not diagnosed and treated promptly, may result in limitation of motion and functional disability. To our experience open reduction and stable fixation with transosteal suturing, allowing early passive motion of the joint, gives excellent to very good final results.