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Abstract Objective To explore the efficacy of Ilizarov technology in treatment of infectious osteonecrosis after surgery of Pilon fracture.Methods 12 cases were selected in Beijing Changping Shengji Orthopedics Hospital from June 2004 to December 2017，these patients were diagnosed as infectious osteonecrosis after surgeryof Pilon fracture，they were treated with Ilizarov technology.There were 8 males and 4 females，with anaverage age of (51±10)years(range：36~69 year).9 patients were classified as type III by Gustilo，and 3 patients were classified as type C by AO.Pathogenic bacteria were Staphylococcus aureus(including 2 cases of MRSA)in 8 cases，E.coliin 3 cases，pseudomonas aeruginosa1 case.The length of the necrotic bone range from 2 to 8 cm，with an average length of 7 cm.6 cases suffered from uppurative arthritis of the ankle，and1 case had talus necrosis.The necrotic bone resection，closed convective irrigation，and Ilizarov's bone transport were used in these patients.BT method (bone transport，BT) wasusedin 4 cases，ASD method (acute shortening distraction，ASD) was used in 3 cases，and ASD method+BT method were usedin 5 cases.Results The inflammation of 12 cases were completely treated.The docking site of tibia and tibia occurred in 7 cases with good function of ankle joint.The docking site of tibia and talus occurred in 1 cases，the docking site of tibia and calcaneus occurred in 4 cases.All bone defect was healed.The length of bone lengthening ranges from 2~8 cm.The cortical ossification of the lengthening part was completely.The follow-up periodwas about 3~14 years and average follow-up time is (8±3)years.No osteomyelitis recurred in these patients.Conclusion Ilizarov technology can effectively treat infectious osteonecrosis after Pilon fracture，and it is worthy of further clinical promotion.
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