Complications in treatment of tibial bone defects using Ilizarov procedure

Abstract

Actuality: tibial bone defects represents really a challenge to orthopedic specialists because tibia, as one of the biggest bones of the skeleton, often cannot find enough bone "reserves" in the body to compensate the post traumatic losses. Especially in circular defects, this bone tissue “crisis” is felt intractable that the only viable solution to keep member remains callus distraction method. All other methods: vascularized bone, avascular allogeneic transplants, induced membrane method remain applicable in partial or small circular defects. However callus distraction method is a difficult, lengthy and permanently marked by various complications. Aim: to review the complications manifested during treatment of circular diaphyseal tibial defects and the measures undertaken to overcome them successfully. „ the paper reflects the analysis carried out on 65 clinical cases of treatment of circular tibial defects. The study group was dominated by men – 48 cases, women being 14 cases. The maximum length of recovered tibial bone defect was 21 cm, the minimal - 5 cm. Most common complications were: infection of the tissues around brooches – 100%; soft tissue defects associated with bone defects - 92%; infections of the bone fragments - 17.8%; 56% delayed consolidation; non unions - 18%; brooches breaking - 7%; intraoperative bleeding - 4.7%; non formation of satisfactory regenerated mature bone - 3.8%; joint stiffness - 88%; segment’s shortening - 92%; misalignment - 12%, ankle and foot edema - 18%; reactive arthritis - 15%; allergic and local exematic response- 3%; painful segment - 5.5% and 11% - local osteoporosis. Results: in all patients claimed purpose has been achieved. However, the level of satisfaction of the healthcare professionals and the patient was influenced by installed complications. Conclusions: postoperative complications of tibial bone defects treatment by Ilizarov method are inevitable. This requires a postoperative conduct with frequent monitoring recklessly the period after the surgery.