Abstract：Objective To explore the clinical effect of bone transport using circular external fixator to treat postoperative infectious nonunion of middle and lower tibia fracture.Methods A retrospective study was conducted on 19 patients with infectious nonunion of the middle and lower tibia who were treated in our department from January 2016 to December 2018.All patients were treated with debridement，one-stage segmental osteotomy and bone transport with external fixation.Of the 19 patients，16 male and 3 female were included，with average age of (46.2±11.8)years (range：37~62 years).We recorded operative time，number of operations，healing index，duration of implantation，length of bone extension，incidence of postoperative complications，and Baird-Jackson ankle function score and HSS knee function score in each cases.Results All 19 patients were followed up.The mean postoperative follow-up was (16.9±6.8)months.The operation times was (120.6±18.6)min，ranging from 100~150 min；average operation time was (1.2±0.4)，ranging from 1~3 time；the average healing index was (39.4±8.2)d/cm，ranging from 31~52 d/cm；the average time with external fixator was (15.2±3.0)months，ranging from 12~21 months；the average length of bone transport was (7.2±2.2)cm，ranging from 4~11 cm.All patient obtained bony healing without reoccurred infection.The average Baird-Jackson ankle score was (83.4±7.1)，ranging from 72~97；average HSS knee score was (89.2±5.4)，ranging from 80~98. There were 1 case with soft tissue incarceration，and soft tissue release was conducted.1 case with shaft malformations，which was corrected after external fixator adjustment.1 case with nonunion after bone transport，which obtained bony union after internal fixation with autogenous iliac bone graft.Conclusion Infectious tibial nonunion treating with bone transport can obtain good clinical outcome.Preoperative design，intraoperative operation，and postoperative treatment，the characteristics of the bone tissue and soft tissue of the surgical site should be fully integrated to actively deal with complications.
高嘉锴，郝赋，牛志霞，毕龙，王陶然 *. 环形外固定架骨搬移治疗胫骨中下段感染性骨不连的疗效分析[J]. 实用骨科杂志, 2021, 27(5): 392-427.
Gao Jiakai，Hao Fu，Niu Zhixia，et al. Effect of Bone Transport by Circular External Fixator in the Treatment of Infectious Nonunion of the Middle and Lower Tibia. sygkzz, 2021, 27(5): 392-427.
［1］余斌，王博炜.外固定支架在创伤骨科中的应用［J］.中华创伤骨科杂志，2020，22(4)：282-285.
［2］秦泗河，郭保逢，臧建成.Ilizarov技术引入中国大陆30年［J］.骨科，2020，11(3)：181-185.
［3］贺国宇，张永红，王栋.Ilizarov技术治疗胫骨骨缺损的优势及改进策略［J］.中国组织工程研究，2020，24(24)：3870-3876.
［4］Sun DD，Lv D，Zhou K，et al.External fixator combined with three different fixation methods of fibula for treatment of extra-articular open fractures of distal tibia and fibula：a retrospective study［J］.BMC Musculoskelet Disord，2021，22(1)：1.
［5］Fahad S，Habib AA，Awais MB，et al.Infected non-union of tibia treated with Ilizarov external fixator：Our experience［J］.Malays Orthop J，2019，13(1)：36-41.
［6］王晓民，唐小莹，孙贵新.胫骨骨折术后迟发性感染治疗的对照研究［J］.创伤外科杂志，2020，22(12)：895-898.
［7］Kamruzzaman M，Mahboob AH，Saha MK，et al.Outcome of ilizarov external fixator for the treatment of gap non-uniting mid shaft tibia-fibula fractures：Ourexperience［J］.Mymensingh Med J，2020，29(2)：284-289.
［8］Özkan S，Nolte PA，van den Bekerom MPJ，et al.Diagnosis and management of long-bone nonunions：a nationwide survey［J］.Eur J Trauma Emerg Surg，2019，45(1)：3-11.
［9］Ma Y，Yin Q，Wu Y，et al.Retraction of transporting bone segment during Ilizarov bone transport［J］.BMC Musculoskelet Disord，2020，21(1)：704.
［10］Iliopoulos E，Morrissey N，Cho S，et al.Outcomes of the Ilizarov frame use in elderly patients［J］.J Orthop Sci，2017，22(4)：783-786.
［11］肖庭辉，林依淼，任晋可，等.单边外固定骨搬运技术治疗肱骨大段骨缺损［J］.中华创伤骨科杂志，2020，22(11)：997-1000.
［12］叶松林，覃晓峰，李成东，等.骨搬移术治疗胫骨感染性骨不连的疗效［J］.实用骨科杂志，2017，23(4)：369-371.
晋公网安备 14010702070875号