JOURNAL ARTICLE

[One stage treatment of infected tibial defects combined with skin defects with Ilizarov technique]

Xing-Guo Wang, Wei Wang, Xing-Yi Wang, Lei Lü, Gong-Qi Wang, Qing-Song Ma, Gui-You Su
Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology 2010, 23 (6): 422-5
20669571

OBJECTIVE: To explore the therapeutic effectiveness of Ilizarov technique in treatment of infected tibial defects combined with overlaying skin defects.

METHODS: Twenty-one cases with infected tibial defects combined with skin defects were treated between 2001 and 2008 includeing 18 males and 3 females with an average age of 31 years ranging from 19 to 43 years. The length of bone defect ranged from 3 to 13 cm (means 6 cm). Skin defect area was from 3 cm x 3 cm to 6 cm x 10 cm; 11 cases combined with drop foot, 5 cases with arthrocleisis of knee. Preoperative X-ray of the affected limb was performed and zone of skin necrosis was marked, then the point and length of osteotomized bone, and scope of bone and soft tissue need for removing were determined. The internal fixation were removed. Opening irrigation, vacuum sealing drainage (VSD), and dressing changing were appllied. The skin was fixed with Kirschner wire and bone was transferred with Ilizarov technique in all patients. The lengthening of bone and skin was carried out for 4 to 7 days after surgery, 1/6 to 1/4 mm once, 4 to 6 times a day. The clinical effectiveness was determined mainly through wound and lengthening of skin.

RESULTS: All patients were followed up for from 6 to 62 months (means 49.5 months). Fourteen of 21 cases received one stage treatment, there was still secretion from end of bone in 3 patients whose bone healed after debridement, the other 4 patients were cured via trimming end of bone and compression fusion. The defects of bone were extended to full length in 18 patients. Abutting end was slightly absorbed and became rattailed in 2 cases, there was lack of blood supply to abutting ends in one patient who was cured via bone graft from iliac bone. Skin defects was cured in 18 patients with one stage treatment, the other 3 patients were cured after infection was controlled. The deformity of drop foot were corrected in 11 patients, and function of knee was improved in five patients. The external fixator was removed at 1.2 to 2.6 years after surgery. At last, bone infections were cured, defects of bone and skin recovered in all patients.

CONCLUSION: One stage treatment of infected tibial defects combined with skin defects using Ilizarov technique has minimal invasion with less complex surgeries, could reduce the time and expense of treatment.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
20669571
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"