Evaluation of the results of surgical treatment of patients who have appli̇ed LRS (elongasyon type single axial external fixator) technique in tibia infected and defected psodoarthrosis cases

Object: To evaluate the surgical treatment results of patients applied LRS technique in cases of tibia infected and defected pseudoarthrosis Materials And Methods: In the study, there are 172 patients who received LRS (Limb Reconstruction System) type monolateral external fixator which a diagnosis of bone loss in the tibial bone, nonunion in the tibial bone and infected nonunion developed due to various etiological reasons, mostly due to firearm injuries, excluding congenital causes, in the Orthopedics and Traumatology clinic of Mustafa Kemal University Faculty of Medicine Hospital between January 2012 and July 2020. Bone losses of the patients were classified according to the Paley pseudoarthrosis classification and Solomin's long bone defect classification. Amount of transport, amount of elongation and callus tissues were evaluated with orthoroentgenogram at Postoperative. Postoperative results were evaluated according to ASAMI (Ilizarov Method Study and Application Association) criteria. Results: 162 of 172 patients were men and 10 were women. The mean age of the patients was 33.2 ± 11.9 (16-76). The average amount of bone lengthening was 6.5 ± 2.2 cm in 85 patients. The average amount of bone shift in 60 patients was 7.9 ± 3.1 cm.According to the Paley pseudoarthrosis classification, 33 (19.2%) of 172 patients were TYPE A1, 10 of 172 patients (5.8%) TYPE A2-1, 7 (4.1%) of 172 patients TYPE A2-2, 37 (21%) of 172 patients 5) Type B1, 60 (34.9%) of 172 patients were Type B2 and 25 (14.5%) of 172 patients were Type B3. According to Solomin long bone defect classification, 40 (23.3%) of 172 patients were A1, 8 (4.7%) of 172 patients were A2, 44 (25.6%) of 172 patients were B1, 12 (7%) of 172 patients were B3, 34 (19.8%) of 172 patients were C1, 22 (12.8%) of 172 patients were C2, 12 of them (7%) were D. Average of fixation time of the patients was 357.9 ± 179.8 days. The average external fixator index (EFI) was 52.9 ± 12.9 cm and radiographic consolidation index (RCI) was 47.2 ± 11.7 xiv cm / day in 122 patients. Complications were made according to Paley's rating. According to ASAMI, the bone and fonctionel results in our study with 172 patients were 87 excellent (50.58), 54 good (31.39), 19 fair (11.04%) and 12 poor (6.97%). 5 patients in whom the target area wasn't union were evaluated as bad results. If we list the functional results in the study conducted with 172 patients, 55 excellent (31.9%) 81 good (47%) 26 fair (15.1%) and 10 (5.8%) were evaluated as poor results Conclusion: Our study supports bone transport with LRS as a safe and successful method in the treatment of bone loss and pseudoarthrosis of the tibia, especially in war surgery, despite the complications and extending external fixator time. Keywords: Bone defect, bone shift, pseudoarthrosis, LRS