Results of bone transport application with ilizarov external fixator in tibial bone defects

Objective: The aim of the study is to evaluate results and complications of bone transport with Ilizarov external fixator Material and Method: 49 patients diagnosed with tibial bone defect underwent bone transport with Ilizarov external fixator were evaluated between January 2010 and January 2019 at Cukurova University Medical Faculty Balcali Hospital Orthopedics and Traumatology clinic retrospectively. 10 patients with insufficient follow-up were excluded from the study. Bone defects of 39 patients included in the study were classified according to Paley pseudoarthrosis classification and Solomin's long bone defect classification. The post-operative amount of transport was evaluated radiologically by means of orthoroentgenogram. Post-operative results were evaluated by Karlstrom-Olerud and ASAMI (Association for the Study and Application of the Method of Ilizarov). Results: 36 were male and 3 were female of the 39 patients having proper follow-up. The mean age of the patients was founc to be 37,4±17,2 (9-75). The average bone defect was 8,1±4,3 cm. According to Paley pseudoarthrosis classification, 15 of the 39 patients (38,5%) were Type B1, 6 (15,4%) type B2 and 18 (46,2%) were Type B3. According to Solomin long bone defect classification, 3 of 39 patients (7,7%) were found to be B1, 1 (2,6%) B2, 2 (5,1%) B3, 13 (33,3%) C1, 17 (43,6%) C2, 2 (5,1%) D2, 1 (2,6%) D3. The average follow-up period of the patients was 34,6±15,9 months whereas the average fixator time was 452,6±182,7 days. The external fixator index (EFI) averaged 72,3±38,6 cm/day, while the radiographic consolidation index (RCİ) average was found to be 55,1±30,8 cm/day. The complications were based on Paley's rating. Of the total complications, 57 were problems, 37 were obstacles, 54 were true majors complications. ASAMİ Bone Results were as follows; 10 (25,6%) excellent, 24 (61,5%) good, 3 (7,7%) fair and 2 (5,1%) poor results were found. Functional results were as follows; 16 (41%) excellent, 13 (33,3%) good, 8 (20,5%) fair and 2 (5,1%) poor. Karlstrom-Olerud functional results were found as 8 (20,5%) excellent, 17 (43,6%) good, 5 (12,8%) was acceptable, 6 (15,4%) fair, 3 (7,7%) poor. Conclusion: Despite its high complication rate and long external fixator time, bone transport with Ilizarov external fixator is a successful treatment method in terms of the treatment of tibial bone defects.